Monthly Archives: June 2009

Context Matters Part I: Learning doesn’t happen in a vacuum

I'm going to try to address several emails at once through a series of posts about what psychologists often call "context" or the "environment." If you've emailed me to ask about swaddling (how long do you do it for? when do we transition babies out of swaddles? will the switch out of swaddling make a difference in the baby's sleep?) or about moving a sibling into another child's room or traveling for a long period of time and coming back home to "old" sleep patterns or differences in sleep patterns at your house versus the grandparents' house… these posts are for you! All those issues and many others concern changes in the child's sleeping environment and those changes, indeed, can make a HUGE difference in how children fall asleep and stay that way. For this post, I'll stick to the more general consideration of learning ANYTHING at all, not just sleep habits. Then we'll generalize in the next post to sleep in particular.

One of the reasons sleep training is usually not a one-shot deal for most families is that as the child develops, the world around him also changes.  So far, we've only touched on one of the most important aspects of sleep training. This issue is actually not specific to learning how to go to sleep on one’s own: it is a fundamental aspect of all kinds of learning, especially in the early years of life but also, to some degree, throughout childhood and adulthood. It’s the role of context. When we learn a new skill, we use all the cognitive resources at our disposal, and it seems as though it is these thinking powers alone that either permit learning to occur or are found insufficient to the task. But learning relies on much more than what’s going on inside our heads. It also relies on what’s going on in the environment.

When a child learns to count, he does indeed require a brain that’s mature enough to grasp the way numbers stand for a sequence of objects. He needs the language skills to utter words that stand for numerical placement. He also needs joint attention and social referencing so that he can pay attention to what is being taught by his parent or teacher. These are all the requirements for counting that rest INSIDE the child's head. But he ALSO needs a great deal from outside his skin. He needs a parent or teacher patient enough to repeat numbers while pointing to objects. He needs a set of objects that are the right size and shape, and are lined up in such a way as to highlight their “countability.” He also needs to be well-fed and well-rested so that he can concentrate on the task at hand. And he needs a well-lit room and a learning space where the objects to be counted stand out from their background and make themselves available to be pointed to or manipulated. In other words, learning depends on context. 

Learning ANYTHING in life is helped along a great deal by contexts that are set up to support that learning. We take all this for granted, and we intuitively prepare contexts to help children learn whatever it is we’re trying to teach them. We don’t try to teach a child the names for colours in a dark room, and we don’t try to teach table manners to a child who has the flu, or who is extremely hungry, or who wants nothing more than to be finished eating and go out to play. We adapt the context to the task and the task to the context. The child’s learning of the task depends on the context in which it’s learned. Finally, skills that are not yet completely formed, or that are still easily lost or forgotten, are best maintained when we reproduce the context in which they’re originally learned. In other words, kids (and adults, BTW) learn particular skills better when these skills are taught in the same (or very similar) environment, over and over again. Table manners take a long time to perfect. But if we want to keep them from vanishing, then we practice them again and again in a context that facilitates impulse control and pulls for social routines.

The role of context in learning and maintaining good sleep habits could not be more critical. We don’t teach children to sleep on their own when they’re over-tired, or going to sleep at grandma’s house, or when their stuffed animal has gone AWOL. And we make sure that the lights are dim, the room warm, the belly full, and so on. We intuitively understand the importance of comfort and consistency, and we carefully prepare the child’s environment to maximize the chances of successful sleep-training. Then, once sleep-training has begun to succeed,  we’re careful to set up bedtime practices that will ensure its continued success. We wait until the child is tired, but not over-tired, we calm her down with stories and other peaceful activities, we sing the familiar songs, the ones that will become bedrock routine before long, we set the lights at just the correct dimness, and we make sure that every nuance of our own behaviour conforms to our child’s expectations.

So one of the most common causes of sleep setbacks is, very simply, a change in the context of going to sleep—often a change that we’re unaware of (slowly it becomes lighter and lighter outside at earlier and earlier times in the morning), or that we don’t see as important (change in diet, learning to walk), and sometimes a change that we can’t control (the child grows out of the swaddle, an overnight disaster trip to grandparents' house).

We'll talk more about how this basic learning principle — context matters — impacts on sleep issues in the next couple of posts. But I think you see where I'm going… What changes in the environment disrupts your child's sleep patterns? How have you adjusted to those changes?

Come join us on Facebook!

"Real" post up tomorrow morning (sorry for the delay — I have good excuses, but won't bore you with the details).

I wanted to let you all know that I've finally managed to put up a Facebook page for the book/blog. I actually had to JOIN Facebook to put up a page. And then I had to learn that I was far more dense than I ever imagined because although everyone and their kid seems to understand how to post and play and DO THINGS on FB, I suck at it. So, yeah, a bajillion hours later, and I think I finally know how to link blog posts to the page and a few other things. The main reasons I wanted to set up a page were (1) to make it easier for you to share information with your friends, if you're into that sort of thing on FB and (2) to set up a seperate site from this blog for discussion topics to be posted. This second reason is really the most compelling for me. If you go to the page, you'll see I've set up a few Discussion threads/topics. Any "fan" of the page can make up any new topic, on any issue that's relevant to you. Ideally, I want to keep a relatively low profile on these discussion threads because I'd like the discussions to be mostly parents supporting one another through various ages/stages and challenges. Of course I'll be following along and learning with the rest of you, but I most definitely do NOT want to moderate these discussions. I get the feeling (and have received some feedback along these lines) that some people don't feel comfortable posting on the blog because it seems more of a space where my "expert" opinion dominates. I'm okay with that if you are, but I still wish it wasn't so at times. So I thought I'd provide another space that parents can take the info they get here and maybe engage in more in-depth discussion about their own personal challenges, as well as provide fellow parents in the same boat with suggestions that have worked for them.

I'm also very open to any other suggestions about how to use the page. I'm a newbie, like I said, so I suspect there are other ways that connecting in that context could help us all out. Come by and let me know what you think. You can either search for Bed Timing or connect via this link: Bed Timing FB page.

Then just add yourself as a "fan" and away we go!

Now, if you're anything like me, you might have some privacy concerns (which is why it took me so long to join FB in the first place). To become a "fan" of the page, your FB name and whatever picture you have associated with that name will be displayed to other fans. However, NO INFORMATION beyond that will be shared with fellow fans (unless your settings are such that anyone in general can view your information). If you want to remain completely anonymous, I completely understand not wanting to join.

I will still be posting regular blog entries at this site; nothing will change in that respect. Let me know what you think!

Reader’s question: Seperation anxiety and marital conflict

Here's a set of intertwined questions and circumstances that many of us can relate to.  B is feeling stressed and confused about this situation. I'm going to take her email in parts. Please feel free to pitch in with your comments and support, as usual:

I'm not sure what to do, and my husband and I are kind of at an impasse
about this.  Our daughter just turned 1, and on occasion has nights where she is wide awake for 2
hrs – nothing seems to be wrong, but nothing seems to solve it. We
usually just rock her and eventually she falls back asleep.

hasten the sleep process, we've tried giving her pain meds (in
case of teething), a half bottle of milk, a sippy of water, cosleeping,
Nothing seems to work except time. We keep it quiet so she doesn't
think it's play time. But if we don't go into to get her, she cries
until picked up, so she isn't content to just play on her own in the

always kind of chalked it up to
teething pains – she is a very slow teether and usually a few weeks
after these  episodes a tooth would appear.  We went through this with
the 9 month sleep regression too though. Right now she just has 2
bottom teeth, and those came in just in late May. I'd expect more are
on their way.

problem – lately she's been
female clingy lately, and quite the mama's girl.  Last night / this
morning she screamed – and I mean hysterical screaming at the top of
her lungs – for 45 mins when my husband came in to relieve me after an
hour.  (The hour she was with me, she just laid in my arms awake and
calm). I
went back into her room after the 45 mins of scream to take her back
from my husband, and he pitched
a fit.  He feels that I'm rewarding her with what she wants (me).  I
don't see it that way at all – I feel that it's our job to comfort her
and if she feels she needs me, damn it I am going to her.  I think it's
really unfair to let her scream for 45 mins to "teach her a lesson". It
would be different if it was 5 or 10 minutes, but it isn't. That has
happened on occasion too, but she surrenders much more quickly.  I
guess I draw the line at over 10 minutes.

So, first off, your baby is likely at a good age to start to make some changes in her sleeping habits if you're not keen on how they're going. In another part of her email, B. asked how separation anxiety affects sleep. We've talked about what could be going through a child's mind starting just before 1 years old and why those changes are likely to keep a child awake at night. But the peak of separation anxiety will likely have subsided by now. That doesn't mean the baby's not sensitive to separations  — now that she's passed through the "object permanence" gates of the 8-11 month period, your disappearances will always be somewhat fraught with meaning. But she should be settling down with the understanding that mommy doesn't disappear forever. So, if you want to apply your favourite, non-CIO sleep-training method (because you say you don't want to use CIO), I'd say go for it. It sounds like these long periods of wakefulness are tiring out your baby and certainly tiring for you and your husband.

don't know who's right, and I don't know how I'm supposed to tell the
difference. I ovbiously don't want to give in to any tantrums and spoil
her, but I really think something going on.  She is usually a pretty good sleeper at night. But testerday she didn't nap at
daycare (an in home provider) – she just wanted the to be held.  She was exhausted and so I know
she isn't really staying awake this morning for fun. She's tired, so if
she is up, something is going on.

Oh yes… I so feel for you. NO ONE is right or wrong in this situation. You both are just tired, frustrated, and you both desperately need a break. If you DO decide to use a systematic approach to sleep-training, I
think it's CRITICAL for you and your husband to get on board with a
plan TOGETHER. It is probably the only way you can maintain any consistency in your sleep-training approach.
If SOMETIMES you hold the baby for an hour and SOMETIMES your husband
goes in and attends to the baby and SOMETIMES he stays there and
SOMETIMES you can't take it and get the baby from him, it's going to be
very difficult for your baby to learn new sleep habits. So… my
suggestion would be for you to sit down one night after the baby IS
asleep and pour a glass of wine for the two of you (if you're into that
sort of thing… I find it a delightful way to begin a marital
discourse on any given parenting issue ;-) Then work out a plan
that BOTH of you feel good about following. If you don't think you can
allow your husband to do the soothing part of the sleep training, then
you make the commitment to always be the one doing it. This is a
perfectly reasonable strategy if your baby is going through a MOMMY
ONLY stage. Most babies do go through this. It's exhausting and often
infuriating and it can feel awfully rejecting to the parent who is
being… rejected. But I can assure you from a developmental perspective that your baby is not being manipulative (she doesn't have the cognitive capacity for that yet), nor will you spoil her to give her more mommy than daddy time; her behaviour is simply
evolutionarily adaptive. And VERY likely, she'll so get over you sooner or later and it'll be all about Daddy and how COOL he is and what a DRAG
you are. But until then, the mommy game may be the only game in town. That doesn't mean you can't sleep-train her; again, I won't tell you what method to use, but whatever you choose, it's likely to work a whole let better now than at 17/18 months. So, if you DO decide that you want to sleep-train and you want to be the one to take
on the major part of the soothing, that's fine; that's what feels right for you. But then I urge you to also give your husband responsibilities
during this sleep-training phase. Not only because you need some help, but also because he IS a valuable part of your family "team" and he needs to feel that his efforts are valued. Those efforts, at this stage, may not be best aimed at soothing the baby when she wakes because the baby has a clear goal of mommy. But he CAN do things to help. He can take the baby off your hands when she's less needy, for example, in the day or on the weekend and let you take a nap; he can rub your
feet while you go in and out of the baby's room at night, make you dinner, and
generally be a kick-ass cheerleader for you. You get the idea here… You guys are in this together and have the same goal: to raise a happy, healthy little girl.

Her screaming kills me emotionally. I feel so guilty when I give her to DH, like I instantly regret
it. I can't sleep when she is screaming like that, so I end up questioning why I didn't just
keep her so my husband can sleep, my daughter is calmer, and the neighbors don't think
we're murdering our child? 

It used to drive me BATTY to see my husband try to soothe the babies when he was unable to do it. I just wanted him to do it better or at least let me take over when he wasn't being effective. It is so hard for us mothers to remember that the father is, and should be, a large part of this child's world and even if our partners are not as good at soothing the baby as we are, they may need to give it a try, over and over, until they figure something out that works for them. 

I'll even go further… And please don't take what I'm about to say
as callous in any way. I have felt EXACTLY how you're feeling. But if
none of the sleep-training that you personally do works to minimize how
long your girl is awake at night, and you are really at your wit's end,
then try what I did the first time my boys were sleep-trained:
Let your husband take over the sleep-training, walk to your closest
restaurant, order a glass of wine (notice a theme here?) and a
main course. This latter part is crucial. Order a full meal so that
you are forced to stay away for an hour. (I remember that I actually had auditory hallucinations in the restaurant — I believed I could hear the cries all the way down the street). Repeat for three days. For
some, this may be disastrous. For others, like our family, after the
third day, I entered a quiet home, with children sleeping and a
husband who thought he was the most kick-ass Papa in town.

I think one of the crucial parts of B's email touches on the incredible stress
that a new baby puts on a marital relationship. There's a whole lot of
research on this "and baby makes three" phenomenon. Here's a review chapter
that you can actually read in its entirety, by one of the top scholars
in this field. This line of research has established that dealing with
the new challenges of infancy can put incredible, sometimes
irreparable, damage on a marital relationship. Did I need to tell most
of you this? Did you need tens of psychologists conducting 100s of
studies to prove this to you? My hunch: not so much. So many of us have
hissed at our partners to GET OUT NOW over our wailing baby's heads.
Countless mothers have felt the competing
desires to take a blessed break from our demanding child by handing him
off to our partner while at the same time wanting to grab the baby back
because YOU JUST AREN'T DOING IT RIGHT. So many of us have bit our tongues, sat on our hands, hid behind doors, willing ourselves to give our partner just 5 more min, just 2 more min, before we can't take the baby's cries for one second longer. It is so, so hard. For BOTH partners. But it DOES get easier, if the couple is willing to talk it out and even to have repeated conflicts that have the chance to repair. Withdrawing from one another, on the other hand, is often much more dangerous for the relationship in the long run. So if you can manage it — even in the middle of potentially the most stressful time in your marriage — keep the communication channels open. The whole family will be better for it.

When the all-night snack bar is closing: Some strategies for night-weaning

Several readers out there are considering night-weaning, with the potential that this may make it easier to sleep-train their babies. I want to emphasize that night-weaning is NOT necessary for sleep-training, but your child may get the sleep lesson faster if he isn't SOMETIMES fed and SOMETIMES not. I wouldn't recommend night-weaning until your baby is eating solids during the day. So, probably not before 4 months and I'm more inclined to suggest 6 months or so. This is mainly because most babies' tummies before 4-6 months are still quite small and they need the round-the-clock feeding to continue to thrive. OK, let's talk about some strategies that might help.

The first consideration is if the mother is breast- or bottle-feeding at night. If you are bottle-feeding (either expressed breastmilk or formula) during the night, then there's a handy little trick that works for a lot of us. Oh… and if you're NOT bottle-feeding and you're dying a slow and painful death from sleep deprivation, you might want to consider handing your partner the bottle and showing him/her the way to the baby's room at 3 am — pump or mix up some formula and away he/she goes (and 3 or more hours of uninterrupted sleep could be yours). Ahem… I digress.  If you ARE bottle-feeding at night or you COULD be (in other words, if your baby DOES take a bottle and you CAN pump or are OK with formula), try this "graduated weaning process":

1. Plan on about 10 days for this process to work.

2. On the first night, prepare the bottle with one less ounce of milk than usual, and replace this ounce with water. This way, your baby is getting the same amount of liquid, but one less ounce of milk. (For example, if your baby usually gets 6 ounces of milk, put 5 ounces of milk and one ounce of water in the bottle instead).

3. Feed baby this amount every time she wakes up in the night, for the next 2 or so nights. Guaranteed, the child will not notice this first stage. Soothe baby back to sleep

4. On the third day, take out another ounce of milk and replace with another ounce of water (so now you have 2 ounces of water and the rest milk). Soothe baby back to sleep.

5. Repeat steps 3 and 4 until the baby starts with the HATE. In other words, continue to replace more and more milk with water. At some point in this gradual process, most babies start noticing and protest. Some protest A LOT. Others, remarkably, very little. Most kids will take a few sips of the now water-with-a-tiny-drop-of-milk and give up, but many will finish the water. Soothe back to sleep.

6. Usually, by the time the baby does start to notice (around the 10-day mark), you will be giving her almost NO milk and you will have been doing this for several days. That means, the child hasn't been getting much nutrition at all from these night feedings for days now.

7. Continue to give the baby water every time she wakes up. Or at this point you can substitute with a soother/pacifier if she takes one and if you're into that sort of thing. 

8. At the same time you're doing this gradual weaning, you should be trying to up the baby's caloric intake during the day. This can be through nursing, formula-feeding or solids.

9. That's it. At the point that your baby is waking up and only getting water from the bottle, your baby is night-weaned. If he's going back to sleep with your help after the water, then he is no longer getting hungry. The whole point of this process is to get to a place — GRADUALLY — where you know that the baby no longer NEEDS the nutrition that he usually got at night. He will compensate during the day.

This is a slow, gentle process by which the baby's body becomes gradually accustomed to getting fed only during the day. At night, the same hunger pangs need not arise anymore. For me, this process was critical to go through before I started sleep-training so that I could ensure that when my boys did wake up at night during the sleep-training phase, they weren't hungry (and I wasn't filled with doubts/guilt as to whether they really needed the food or not). 

Night-weaning is quite a different ball game if you're exclusively nursing during the night. In this case, transitioning usually requires a whole lot of support from your partner, if you have one (and if you don't, I would enlist the help of family or a close friend; otherwise, this can be a very painful process for one person alone… not impossible, but HARD).

Your partner needs to start doing more night soothing during times when the child is used to being nursed. Also, because it's very, VERY hard to just offer the breast for a couple of sucks and then take it away, it's harder to GRADUALLY decrease the amount of milk the child receives. So, sometimes, this is a more hard and fast weaning process. Many mothers report that cutting off the night feedings entirely was much easier than trying to cut them down to just one or two. Mostly because the baby doesn't get the idea that sometimes you're allowed to nurse at night and sometimes you're not. So, when the baby does wake up, the partner starts to soothe. As usual, it always depends on your child, but the partner's soothing could involve back- rubbing or cuddling in bed (especially if you co-sleep) or in the crib or, more likely, the process will involve being out of the bed, rocking and/or bouncing the child.  The first few days are going to be the hardest. Sometimes, mom needs to be out of the room every time the baby wakes up and wants to be nursed. If the child is old enough to understand words and some more complex ideas, saying things like this might help:  "boobie is empty now and needs to make more milk and will be ready in the morning", "you can have it when you see the sun", or "boob is sleeping".  In the morning, you'll need to be prepared to nurse for a long time.  The soother is a big help here, again, if your baby takes one and you're into giving her one.  Singing also has helped many women.  Instead of nursing to sleep, some kids quickly switch to being sung to sleep, some favourite songs help, but introducing some new lullabies can be helpful too. Some kids adopt new soothing behaviours like belly-rubbing (the baby's or yours), playing with mommy's hair, sucking their thumb, and so on. You can also try to introduce new items to soothe with like lovies, stuffed animals, blankies, etc.  Lots of love, affection, cuddling and discussion of what is going on (even if it's a wee lie) can help the older ones especially. Also, keep in mind that SOME kids are not big cuddlers and don't NEED the tight shmushing  to compensate — we as mothers often try to pull our kids physically closer during these times when they might feel best with a little space of their own. So, keep an eye out for these signals and try not to take it personally (HA!) when your child pushes you away a bit and starts to self-soothe instead.

This is a tough transition. For both the baby and the mother. Be kind to yourself. Cut yourself some slack. Try to ease the guilt you might feel with lots of playtime and cuddling during the day. 

Anyone been through night-weaning and have some extra pointers? Words of encouragement? Horror stories? Anyone want some support while thinking about starting this transition?

Lest we forget… (or do whatever works to get you through the day/night before 3 months old)

I've received several emails in the last month about short nap cycles. The questions revolve around 3 things:
1. Is it normal for naps to be SO SHORT (for example, 30 – 45 min) at around 2-4 months?
2. Is it ok to help make naps longer by [enter whatever means the mother has finally found to put her child to sleep and keep him that way for more than 10 min]?
3. How do I lengthen naps?

For once, I thought I'd be a little more succinct. My answer to 1 and 2 is: YES!  Babies before 6 months or so often wake up from naps very quickly, corresponding to their short sleep cycles. To answer #3: Oftentimes you can get them BACK to sleep, with some help from one contraption or another (swings, bouncy/buzzy chairs, slings, stroller, carseat — in or out of the car, breasts, bottles).

There are far too many books out there telling you NOT to use these "sleep crutches" because babies will get used to them and NEVER. EVER. EVER. SLEEP. ON. THEIR. OWN. I come from another perspective. Because most babies' nap cycles don't lengthen until about 6 months (and they often do so with no intervention on your part), trying to eek out a nice long nap from your infant warrants any arsenal out there. I went back through some very badly filmed clips of my many attempts at getting my boys to nap during this early stage, just to remember how crazy hard it was to put these little guys to sleep and keep them that way. As you can see, I used any strategy (and many more not filmed). Swings, bouncy chairs, slings and nursing… all for the elusive 1 – 2  hour nap. They never napped that long in one stretch until they were 5 months old or so. And after about 6.5 months, they were slowly weaned off all swings and such.

So, my bottom line based, in part, on my very unscientific sample of 2: In the first 3 months or so, I would use any means necessary to get your child to nap and stay that way for more than 15 min. I did…  (Please excuse the quality of the film. Oh, and the CHEESY, high-pitched squeaking with which I spoke with the camera/babies. My only excuse was SEVERE sleep deprivation).
Download Nap strategies

What are the long-term outcomes of letting your baby cry while sleep-training?

One of the main concerns that parents have when they first start considering sleep training is whether they will harm the child in any significant way if they allow her to cry for some set length of time.

There's a reason why the answer to this question is not common knowledge already. Believe me, if extended crying had a straightforward connection to any serious harm to children, you'd know about it already. This is why I hate giving newspaper and radio interviews sometimes. And it's why this post has taken almost a week to write. Most people want a one-liner. They want the bottom line: Is it good or is it bad to let your baby cry when you're sleep-training? OF COURSE you want the bottom line. You want to do right by your baby. But the one-liner just doesn't exist. ANYBODY that tells you that the research is straightforward, that science has come up with a real answer, is simply not telling the truth. Intentionally or not, WAY too many sleep experts — from the "Attachment Parenting" camp to the hard-core CIO fans — profess that science has come up with the answer as to whether crying harms children in the long run. It's simply not true.

Mother & Kids crying Having read far too many of the original studies that are related to the topic, here's my take. My best answer as to whether it harms a child when we let her cry for a while when sleep training is: It depends, but it probably doesn't damage children in any significant way (long-term outcomes, self-esteem, bond with parents, etc.). It depends because some kids are particularly sensitive to separations; it depends because parents can get so resentful of failed attempts at sleep training that they treat the child poorly and that, in turn, has detrimental effects (and we can't tease apart these effects from the amount of crying the child is doing); it depends because some children's crying, even the most minimal amounts, sends some vulnerable women into a tailspin of postpartum depression and we know that's not good for kids in the long run; it depends because some children become physiologically so aroused when they cry that they vomit or hyperventilate and, well, that's not good for some kids either; it depends because some children cry MORE when they're being rocked to sleep by well-intentioned parents than they would if they were left alone and ignoring that need that some kids have to be left alone (which they can't articulate) may actually be equally detrimental to some kids; it depends because many couples go through significant marital conflict when it comes to deciding how long to let their baby cry and marital conflict has repeatedly and consistently been found to have long-term negative consequences for children. So… how would you tease out whether it was the length of crying during sleep training or the marital conflict about the crying that made the biggest dent in a child's developmental outcomes? (You COULD do it, but the study would be very complex and it hasn't been conducted yet). So, yeah, it depends (and I could go on for much longer about all the factors that make this seemingly simple question so very, very complex).

But… however complex the issue may be, there are indeed studies that have been conducted to tackle the issue from various angles. Let me point you to some that have brought me around to my general conclusion:

In the review article in the journal Sleep that I keep referring to, they went through the best studies out there (a total of 52) and concluded that there were no appreciable differences in the effectiveness of the top 5 sleep training methods assessed (from CIO methods, to Ferberizing, to more gentle methods like "positive routines" or faded bedtimes). Then they looked for "collatoral damage" if you will. Here's the quote from the article directly: "A total of 13 studies selected for this review reported results pertaining to child daytime functioning such as crying, irritability, detachment, self esteem, or emotional wellbeing… Adverse secondary effects as the result of participating in behaviorally
based sleep programs were not identified in any of the studies [Did you catch that? NONE of the studies showed negative effects, even the CIO ones]. On the contrary, infants who participated in sleep interventions were found to be more secure, predictable, less irritable,and to cry and fuss less following treatment.Mothers indicated that behaviorally-based sleep interventions had no effect
on maintaining the practice of breast feeding or on infant’s total daily fluid intake."  If you go to the original paper I have linked, they cite all the studies that brought them to this conclusion — they're well-designed, published in reputable journals, reviewed by a committee of scientific peers.

Then there's a group of studies that don't directly address the question, but they're related in important ways.  Researchers have long been interested in whether crying itself is a bad thing for kids. Several groups of researchers have studied colic and its long-term impact on children. Most of them have come up with the conclusion that early, "excessive" crying (often referred to as colic) does not lead to poor outcomes for children (unless there are ADDITIONAL problems in the family like depression, marital conflict, poverty and so on). It may be that when crying PERSISTS over a longer period of time (rather than being temporary, which is the case for any sleep-training process) that negative outcomes become associated with crying. Here is one of many review articles that summarizes the findings.

Other researchers have been focusing more on the stress hormones released during crying fits and how those may impact on the long-term development of children. Crying is a physiological response to stress and it involves increases in blood pressure, heart rate, and cortisol levels (indicators of stress). A fantastic recent review article — by Megan Gunner, one of the most well-regarded neurobiologists in the field — goes through decades of research on stress levels and their neurobiological effects on children's long-term development. She, like many of her colleagues, conclude that PROLONGED high levels of stress (that are often, but not always, accompanied by lots of crying) leads to loads of poor outcomes for children. But again, this is PROLONGED stress — over months and years often — NOT crying that happens over a week or two and that lasts for short periods, relatively speaking (even an hour is a short period in this line of research). Just to give you an idea about the level of prolonged stress we'
re talking about here, these researchers study children from abusive and neglectful families (physically and emotionally), children who have recently been adopted out of institutions known to have neglected babies and children for years at a time (like the Romanian orphanages of the pre-Revolution era), and so on. Yes, stress can have a negative impact on children. Yes, of course, our jobs as parents is to try to minimize the amount of stress children go through. But the serious negative long-term outcomes associated with chronic elevated levels of cortisol are WORLDS away from even the most die-hard forms of CIO. And this is where I get on my soapbox: People who call themselves experts who cite this body of work as rationale for never allowing your child to cry (alone or in your presence) for some prescribed duration of time during sleep-training are seriously misrepresenting this body of research.

 One last point that I tried to emphasize in the book: We all want to have the most stress-free sleep-training experience for both our children and ourselves. EVERYONE wants to minimize their child's distress during sleep-training. The problem with picking the "right" sleep-training method for your child — the method that will provide the best results in the shortest period of "training" possible, with THE LEAST AMOUNT OF CRYING — is that, depending on the child, the most gentle sleep methods can have some kids wailing for hours out of frustration and the most hard-core CIO can have other children sleeping in 5 min. I have heard MANY stories from mothers who have used "no-cry" sleep solutions and been frustrated to high-hell with them because their child interprets these gentle methods as a big "tease." These children cry MORE when their mother is present, in the room, but shushing them and inching little by little away from them. They can cry for hours and hours in this type of frustrating experience. For other mothers, these same methods resulted in their babies sleeping through the night through a painless, cry-less transition. Just as many mothers SWEAR by "graduated extinction" or Ferberizing, claiming that before they Ferberized, their babies would cry in their arms for hours during rocking and bouncing sessions; during sleep-training, they cried LESS. And of course there are plenty of parents that have tried CIO methods and been traumatized by the amount of incessant crying their babies endured.

Crying in and of itself will not damage your child for good. There have to be other factors working to do that kind of damage. Yes, some children may show signs of insecurity the next day. Other children will show the exact opposite, seeming more jolly than they had PRIOR to sleep-training. If you feel that the method you're using is adversely effecting your child, then stop. Recharge for a few days. Try something else. Try again in the next optimal developmental window.

And as one who has ALMOST come through the other end of worrying about serious sleep concerns with my children, I have to say that I now have SO MANY more opportunities to screw up my kids. Sleep-training now seems like a drop in the "am I messing up my kids for good" bucket. Now I can yell at them for throwing food and worry about scarring them for life, I can be an irritable, tired, inaccessible mother when I get home from work and recall all that research on "the distracted mother", I can feed them things I don't know I shouldn't be feeding them because I don't do enough research, I can put chemical-ly sunblock and bug spray that will MESS WITH THEIR BRAINS FOREVER!

Ah… the joys of motherhood for all of us guilt-prone parents out there…

Reader’s question: Should I stay or should I go now… (Or… A whole lot about transitions and 2 year olds and a little about sleep too!)

Although this isn't a question directly related to sleeping only, I still think it's a good one for discussing the more "stable" age of 2 years old. I wanted to post this question ASAP since it comes from a mom, K., due with her second child in SIX DAYS! My guess is there won't be a lot of blog reading in the near future for her…

I have a daughter who is 21 months, and I am expecting a boy at the end
of June.  My daughter had a rough start with colic and reflux and I
stayed home full time for the first 6 months after she was born.  Since
she was 6 months old I have been working 2 days a week.  We have a
nanny for the 2 days that I work and it has worked out really well.  My
daughter has grown into a very happy, fun and generally mellow toddler,
although I would say she is sensitive and is definitely in the midst of
the "Mama-must-do- everything-and-Dada-is-not-an-acceptable-substitute" phase right now.  I am hoping we are at least past the peak before the baby arrives.

I was offered a very tempting full time job that would start in
Sept/Oct after my maternity leave.  I have always expected I would be
going back to work full time and this opportunity is something that I
am excited about (even more so considering it sort of fell in my lap in
this economy!).  The catch is that the job is in another state.  But,
it happens to be in a city that is less than an hour drive from my
parents, sister, cousins, etc.  I am not put off by the idea of moving
and would really like to be closer to family but I don't know if I
taking the job would be disregarding or underestimating how hard this
might be on my daughter.  Taking the job would mean that within a ~3
month time span she would 1) have a new sibling 2) no longer have me at
home 5 days a week 3) have a completely new and different caretaker
(possibly daycare) and 4) have entirely new surroundings (new
neighborhood, new house, new bedroom, etc)

Clearly there is no
getting around the adjustment for a sibling but the other variables are
under my control because I don't have to take the job.  I do have some
concern that the adjustment of working full time is going to be harder
than I expect for myself, but when considered in isolation I am fairly
excited about the job.

So I guess I am looking for input about
how much change might be too much change for a toddler that will be in
the 22-25 month stage when all this would happen?  On one hand I know
that kids are very adaptable and these changes would be stretched out
over a few months, but ideally I don't want to be blind to the distress
I might inflict if I take it.  I can imagine there would be sleep
disruption and possibly behavioral issues, but I am not sure what it
might entail.

Do you have any advice or insights into how to
make these transitions as smooth as possible, or would I be signing up
for much more than I realize?  Is it too much adaptation to expect from
a toddler given that these would be choices not forced on us?

I love this question because there's just so many factors to consider and so many of them touch issues that many of us have had to deal with. I'll tell you right now I won't nail them all. But let's try to take this apart so we can see what this decision will really entail. K's done a great job of thinking all the various parts of the transition through. The main concerns seem to be:

1. Is this an ok age to make a bunch of changes in a child's life?
2. How much change can a child take without some significant level of distress (which, of course, K doesn't want to inflict on her daughter)?
3. What sorts of things are there to consider in order to make this transition go as smoothly as possible?
4. How will K's daughter respond (behaviourally and in terms of sleep disruptions)?

There's one more issue that I think is at stake here, although K doesn't mention it explicitly and that is:
5. To what extent is it ok to prioritize my own professional and personal preferences over some level of distress from my daughter?

All of these concerns are so intricately intertwined that it's tough to deal with one without considering the others. The bottom line is this decision will be about balancing the various needs of all family members. Let's start with #1: This is a relatively good age to go through changes in the child's life. Your daughter is just heading out of the toughest part of the 18-22 developmental upheaval. Of course, these are rough estimates of age boundaries so it would have been nice if your daughter was slightly  older, but still, she should have covered most of the crazy neediness/clinginess/crabbiness by then. But by 22 months or so, your child is more calm, more stable, and more secure than she was just recently. The massive cognitive changes ushered in by the 18-22 month shift have begun to consolidate. She has gotten used to being a social player in a social world. She understands what you require of her at meal-time and bedtime. Which means that she understands rules and she can adapt to them if she has to. This age can be a real delight because they start getting how fun it is to FOLLOW rules and to be a part of the family in whole new ways. But they're also now attuned to separations in a way they weren't before 18 months or so. You’re dealing with a child who is a lot smarter and more verbal than ever before. Driven by insecurity and anxiety about separations of any sort, these skills will be put to use to get your attention and comfort as much as possible. But still… making the big changes you're considering will be a lot easier now than at 2.5  years old.

#2 is about how much change is too much change. There's no REAL, data-driven answer to this of course. It all depends on the child and her sensitivities, it also depends on the TYPE of change and it also has a lot to do with how the parents are coping with the changes. She's now taking a whole lot of social cues from you, so if mom and dad are happy and excited about the next move, she will tune into that and likely join in the fun. And the TYPE of change is important here also. Yes, she's leaving her nanny and her house and neighborhood. But she'll be gaining much more access to grandparents, aunts, uncles, cousins and all the warmth and gushing love and excitement that could entail (never mind all the extra support you will get which will, in turn, help you parent with less stress). As you say, the sibling is coming whether she likes it or not. That will be a HUGE transition to deal with and you've thought about this big change deeply. But it actually may be EASIER for your daughter to deal with a new sibling if you do move. Whacky thought, huh? But here's where I'm coming from: Many parents report that the best thing they ever did for the older child to cope with a new sibling is to put him/her in daycare. There, the child gets lots of attention from other adults, she doesn't have to fight mom for her love and affection, and she really feels like she's becoming a "big girl" with a "baby sister" at home. Then when she comes home from daycare, she can have "special time" with mommy while dad takes care of the baby for a while. Your daughter will also have extra access to a bunch of loving adults, her extended family. This may possibly go a long way to buffering the rejection she may feel from mom being with the baby so often.

And here's a crucial point: What WON'T change is mom and dad's love and affection for her. At this age, children aren't as attached to places as they are to their primary caregivers. If they stay stable, predictable, and provide the same love and limits that were set in the old context, chances are they'll adjust quite well in a new place.

#3: What are some practical things to consider if you DO decide to move… I have a few thoughts, but it would be great if anyone else has made a significant move like this one to pipe in with further suggestions.

- Talk about the move with lots of excitement and joy. Plan TOGETHER with your daughter what her new bedroom will look like, how often she'll see grandma, and so on.

- Even if you DO feel lots of anxiety about how she'll cope, don't overly project those anxieties onto her. In other words, you want to let her express her fears of moving, her anger at her new sibling's arrival, her anxieties about not being mommy's little girl, but you want those to mostly come from her. Kids pick up our worries so easily and make them their own, even when they weren't there originally. Open ended questions that provide some choices help if you notice her feeling angry or sad. Something like:  "Are you mad or sad or something else?" Why? Is it because of mommy or daddy or baby?"

- Try to leave yourself several weeks open before you go to work at the new job. So, move several weeks before your mat leave ends. That way, you can put your child into daycare (or whatever arragement you choose) in the next city and deal with any transitional anxieties or behavioural problems before you also have to worry about being on time for work. 

- In terms of sleep specifically, try to mimic the context that she was sleeping in before as much as possible. Go through the same bedtime ritual, play the same music, read the same books, use the same blankets. Put her to bed at the same time and try to enforce those limits as much as possible even though she will surely push on them. This is going to be a time of heightened anxiety and our temptation in these times is often to become more LAX in our rules about sleep. The paradox is that this is exactly when children need us MOST to remain firm, so that they feel like their world is a predictable one, one that can't be shifted easily by the little rages of scared children. They need us to say "everything will be alright, you have to follow this rule, as you always have; we are the big people here and we'll take care of everything."

- Invite lots of family over to your new place early on, even if you're still living in boxes. This will help your daughter realize how great the new move was and how much more love and attention might be hers to enjoy (make sure that you give your family a heads up and ask them to hold and play with your older one as much or more than with the new baby).

#4 In terms of how your daughter will respond, as you can see, it depends on loads of factors and even if you do everything "perfectly" (which doesn't exist), she'll still have normal fears and anxieties that she'll have to work through with your help. Yes, that might entail more tantrums and less sleep. And if you're prepared for this and understand that it's a normal part of adjusting to novelty, it does
n't have to be a horror-filled time at all.

And this bleeds into the unexpressed issue #5: The bottom line for me is that if this job is your dream job and it's also a great location that affords you so many benefits that you look forward to (professionally and personally), then go for it! Your children will adjust, perhaps much easier than you anticipate. And if your daughter does have some difficulties, it's interesting to note that with the very, very rare exception, "biographical memory" doesn't really start until age 3 (in other words, she won't even remember the move by the time she's around 5). I'm partly kidding here (biographical memory does begin usually at around 3, but that's not the point). The point is that you are a thoughtful, engaged, empathic parent who cares deeply for her child's emotional well-being. That will pull her through almost any dramatic transition unscarred and likely better for it.

Good luck and keep us posted on your decision, if you can!

Going down at bedtime easily, but waking up frequently

Thanks for all your feedback on the last post!  I really appreciate
your input and it has rejuvenated me. Maybe I'll just put up a "needy,
insecure" post every month or so and get my fix for your collective
voices… For what it's worth, I completely understand the tendency to
lurk (I was one of you for a long, long time) and I really am cool with
it. Having said that, it's always great to read your feedback, positive
or negative, and not JUST because I'm needy and insecure. It also gives
me fodder for more material to blog about.

So today's post is
going to try to address some of the questions in the comments section
about what to do about multiple wakings. For some people, this doesn't
seem to be under the same category as "sleep training" per se because
the child has no problem falling asleep at bedtime, but he or she DOES
end up waking up multiple times and then can't go back to sleep without

First off, I have to say that this is indeed part
of the whole "sleep training" area. As many of you know (whether by
research or by just plain observing your infants), children cycle
through light and heavy sleep throughout the night, waking many times.
What they're actually cycling through is REM sleep (Rapid Eye Movement:
the light sleep during which we dream) and non-REM sleep (of which
there is the light, medium and heavy variety). They go through many
more cycles than adults do and they need lots of that heavy sleep to
function properly. So, the trick to decreasing the night wakings isn't actually about decreasing them at all
but, rather, we need to teach them to put THEMSELVES back to sleep when
they wake up (as adults, we also put ourselves back to sleep in the
middle of the night, sometimes several times per night, mostly

Part of the reason that many kids don't have a
problem falling asleep in the first place is that we usually provide
them with lots of loving help. Most parents I've talked to have very
little problem with spending some reasonable amount of time rocking,
bouncing, singing and shushing their babies to sleep at bedtime
(provided it's not a 3-hour marathon). It's one of the nicest parts of
early parenthood for some of us. The problem with it, however, and this
is really a tough one to swallow, is that we are teaching our babies to
fall asleep with these "props." Richard Ferber talks a lot about these
cues (btw, he really is not the evil CIO guy that many make him out to
be; the newer edition of his book
is very well-researched, well-written and has some great information
about sleep patterns, biological rhythms and empirically-based
strategies that really work to deal with nightmares, night terrors,
etc.). Elizabeth Pantly
also does a good job of explaining sleep cycles and the importance of
teaching children to put themselves back to sleep. So, one of the first
"causes" of multiple wakings is the child's lack of experience and
ability to put himself back to sleep. What we try to do when we sleep
train is provide the child with appropriate "tools" to fall back asleep
when he wakes up (for example, we use pacifiers, blankies, teddies,
white noise, music, or in many cases, nothing at all except a dark room
with appropriate temperature and a peaceful environment).

course, some children fall asleep on their own easily at bedtime
because they're simply exhausted and their body is drifting into a
natural sleep cycle that they just roll with. However, in the middle of
the night when they reach the light sleep part of the cycle, they may
startle awake and have no clue what to do with themselves. The natural
instinct is to holler for mom or dad to help him out.

So… what
can we do about these night wakings? Mostly: Teach the child to go to
sleep initially by himself. That doesn't mean you have to cut out the
rocking or singing or cuddle time altogether. Just don't put them into
a deep sleep through those methods. And then use your favourite (UGH)
sleep-training approach for every opportunity that the child needs to
fall asleep (bedtime, night wakings, naptimes). That means using the same "gentle" or "graduated CIO" or
"no-cry" or whatever method every single time the child wakes up. Use
those methods until the child learns to put herself to sleep during all
appropriate times. A child needs many, many repetitions to learn a new
skill. So, if most of the time you're doing a pat/shush/pick up/put
down method of gradually teaching your child to soothe himself to sleep
and then other times you let him cry for a few min and yet other times
you nurse him to sleep, he just won't be able to "get" it quickly. The real problem for most of us is that at 8 pm, we can pull off almost any elaborate training method, but at 3 am?! Then AGAIN at 4 am?! And 5 am?! The probability of consistently teaching ANYTHING at those hours with that little sleep starts to seriously decline. 

And all of this gets SIGNIFICANTLY more difficult if the child hasn't been night-weaned. Because when the child wakes up, he's usually fed. And whether that entails a breast or bottle, it requires a parent to do the feeding which, at least for the first stage of infancy, usually soothes the child back to sleep. So, it's very hard for a baby to learn to put herself back to sleep when most of the time a parent gives her milk and that works beautifully to ease her back to dreamland. THIS IS ALL GREAT. No problem whatsoever if everyone in the family is happy. And for the first few months, the multiple wakings are usually expected and tolerated to some degree. HOWEVER, 2 major things start to happen:

1. After the fourth, fifth or sixth month, many of us start to lose our minds from the sleep deprivation. I'm not talking about being a little groggy, a little tired, a tad slow. I'm talking seriously brain dead, dangerously impaired, potentially depressed, perhaps bordering on psychotic, and definitely less fit to parent. Even the most well-intentioned mother may lose it by the 6th month of 4-6 night wakings.

2. Around the 4-month mark, most babies do NOT fall asleep immediately after being fed. OH THE INDIGNITY!  Not only is the child waking up 5 times per night, but the regular routine of nursing or giving him a bottle isn't working to calm him back to sleep anymore. Now there's more bouncing, rocking, shushing, patting, and pleading which can last SO VERY LONG. And seem even longer at 3, 4 and 5 am.

That's why I generally recommend that parents try to night-wean before attempting to sleep-train. Because if the parent is going in sometimes with a bottle or boob and other times trying to use some sleep training technique, it makes it MUCH harder for the child to learn what the deal is. It's not impossible, but it IS harder. I want to be clear: This is NOT a recommendation to night-wean at any particular age. It's a rather straightforward consideration: if feeding your baby throughout the night is more important to you than your ability to sleep through the night, then DON'T night wean. If you are desperate to sleep-train and you want to make the transition as easy as possible, then night-weaning will probably help reach that goal.

So… now that I lost and just re-wrote half of this post (STUPID Typepad… *&&#^#%#%!!), I've lost steam and I'll get to some night-weaning methods in another post soon.

Comments… or lack thereof

Real post coming later today… I just had a quick few questions for those of you willing to delurk briefly. I'm relatively new to this blogging thing and I'm wondering about the lack of comments on most of the posts (the hits on the blog are reasonable, but there's almost no comments on most posts). I'm totally fine with that being the way this blog is going to roll if it comes to that (I really enjoy writing here and the emails I get, although I'm behind in responding, seem to suggest that this is a good forum for answering people's sleep-related questions). But I did want to make sure that there isn't anything blocking people from commenting (with the LARGE caveat that I was a lurker at most of the blogs I read when I first stared reading them, for a variety of reasons). So, a couple of questions for those of you willing to share:

1. I've had two people email me about problems they've had posting comments. These seemed to be technical problems (they'd post, and then their comment would disappear when they'd refresh). I've tried to find the problem, but I can't figure it out. But I also don't know if it's just a bug in someone else's software or computer and not a Typepad problem. If you HAVE had this problem, and you still are experiencing it, I would REALLY appreciate a quick email ( letting me know this is the case.

2. Is this just not the type of blog you would comment on because it's largely "information" being put out there rather than a personal blog per se (the latter may seem more like a conversation and this blog may seem more like a one-way distribution of research or something)?

3. Are there topics that you're interested in that I haven't covered and therefore you don't really have that much to say on the issues I've posted?

4. Are you just so damn sleep-deprived and brain dead that the thought of putting a few words together on a public forum fills you with horror?

5. Am I just overthinking this and I should just get on to the "real" posts already?

Any and all thoughts are very welcome (critical or otherwise. Really.)

Reader’s question: Changing sleep habits at 12 – 16 months

Here's a question from someone that I can finally feel good about saying "Go for it!  This is a GREAT time for making some changes!" After that volatile period of 8 – 11 months that we've talked about at length, there's a relatively peaceful window between around 12 and 16 months (with the caveat that some kids do start walking around this age and for SOME kids, this can be very disruptive for sleep… but for most, this is a nice, stable stage).

My son is 11 months old and up until now has been breastfed and co-sleeping.
At the moment, I'm trying to wean him off of night feedings, he's
been pretty good about it, b/c he's sleeping with my mom and I'm in
another room, but he can't sleep unless someone is beside him. I really
want to put him in his own crib/bed but I thought night weaning should
come first. I'm not sure how to go about making the shift from
co-sleeping to alone sleeping. Also, when is a good time for this? How
long does it take for him to learn to put himself to sleep when he
wakes up in the middle of the night? How long before I can start
sleeping in the same room with him?

First off, I think it's a great idea, if you can do it, to night-wean before making big changes with the co-sleeping situation. It's not necessary, but it sure makes it a lot easier. To answer your question about when is a good time to go from co- to alone-sleeping, you're just about to enter one of the best windows right now.  Why?

Sleep training at this stage gets a boost from the toddler’s sense of autonomy, he has a new-found interest in the nonsocial world, he's relatively independent and secure, and he's developing a real sense of connection and social power through the beginnings of language. Most children some time during this stage begin to walk and they are SO INTO getting around and exploring… which makes them a little less into you. Many kids this age can bounce back from emotional challenges, they don't need to cling desperately to the image of a recently departed parent. However, sleep training at this age is also hampered by the 1-year old’s savvy. This kid has just emerged from a phase of relatively intense separation distress. Separations are no longer neutral. They are associated with feelings of loss, anxiety, sadness, and frustration. Although the peak intensity of separation reactions has passed by now, such reactions have not disappeared. Not at all. For the rest of his life, the child will never be entirely free of the potential for pain and anxiety that comes with being left alone and the sense of helplessness that goes with it.

As a result, the 12-16-month old toddler may defy your efforts to change his bedtime routine. He WILL whine, or yell, or cry to get you back, aware of the power of his voice to bring you back. Introducing a new stuffed animal into his "new" crib might help. Music to keep him company while he's trying to fall asleep may also help. Bedtime rituals, consisting of stories or songs that emphasize his connection to you and to the world may also be a great way of bridging his day and night. This child, so autonomous an hour ago, needs to connect with you, needs to know that you are still within range. He needs to know that separation is not permanent, and that you’re going to come back of your own accord. He needs to feel your love and your care, to know that he is the object of your attention and concern, and that he can call to you when it’s time for reassurance. When he calls for you, at least at first, it's a good idea to let him know you'll be right there. He's used to you being with him every moment of the night (or with your mother). So, if you can feel the confidence and independence that your child is feeling through the day and trust that he can go through the night with minimal intervention from you, then transitioning him to his own crib is likely to work. As I've said before, the method that you choose to make this transition is up to you.

Many of the pitfalls of sleep training at this age emerge from your child’s spirit and his intelligence. His hands will find a way to make contact with every object on the dresser—that tube of cream, the box of tissues, the baby wipes, the pictures on the wall you thought were out of reach.  Whether on his way to the crib or once in there, he will use every opportunity to play and explore rather than acquiesce to sleep. And he may be clever enough to capture you in his play (I remember the ridiculous game that BOTH my boys got into of throwing their stuffed animals on the floor, one by one, each time screaming "oh-oh mama!" each time forcing me to come back up and toss the animal back. TEN. THOUSAND. TIMES. a night). You may see this as bedtime, but for your toddler it’s just another episode of play time. But whatever the obstacles you encounter, 12-16 months is a far easier time to initiate the shift from co-sleeping to sleeping on his own than either of the periods surrounding it. You just came from a stage of peak separation reactions combined with social referencing,  and you’re about to enter a stage when the toddler’s whole social-emotional world is turned on its head, when defiance and autonomy compete with abject neediness and insecurity.

In terms of the specifics of how long will it take for him to learn to
put himself to sleep and how long until you can sleep in the same room
again, I can't give you a definitive answer. There are huge differences
among kids who transition from co-sleeping to sleeping on their own.
Some have NO PROBLEMS at all, much to the shock of their parents. Some can take more than a month to make the transition slowly. And still others don't make the transition during childhood at all, if the parents decide the change isn't worth the stress and tears. Some kids are most amenable to the more gentle, gradual approaches (for example, you first move the child to a pack and play right next to your bed and hold his hand or rub his back through the night, then move the p & p a bit farther from you every day until the baby is essentially across the room, in his crib). While other children find those techniques ultimately frustrating and confusing, but respond beautifully to a straightforward Ferber-like method of checking in on the child in the crib at increasing intervals.

GOOD LUCK!  Anyone else have good or bad luck sleep training during this stage? What worked or didn't for you?