Here's a question from N., the gist of which represents a significant number of emails that I receive.

First and foremost, this is SUCH a tough age. I remember the panic I felt when I realized how much longer this whole infancy thing was going to last. At the time, I couldn't imagine making it "to the other side." A few thoughts: First, your baby actually does need to wake up at least a couple of times during the night to be fed. That doesn't mean she needs to wake up every hour for that nourishment, but it's good to keep in mind that the vast majority of infants need their stomachs re-filled every 3-4 hours or so. Second, you may find that your baby hits 3 months old and naturally starts sleeping longer stretches (and not necessarily on top of you either). These shifts may occur naturally, without you doing anything at all because those first 2.5 months are filled with huge biological changes that are settling down right about now. But if your baby DOES continue to wake up every hour or two and does not settle down easily afterwards and if you simply can't go on like this much longer, you can certainly consider some form of gentle sleep training methods.

As I mentioned in Part I of the 3 to 4 month stage description, this is the only stage that I am somewhat hesitant to recommend because the distress levels of the baby really do need to be monitored by the parent. But on the other hand, there are several reasons why we included this stage — in the book — as one of the
possible periods to sleep-train:
1. There are DESPERATE mothers like the one who posted the question who can't go on feeling sane without some change. I don't know this particular woman's circumstance, but many mothers also either need or want to go back to
work by the time their child is 3 months old. These mothers often have no
choice but to try SOMETHING. My main point is that if you feel you
have to do something, don't try sleep training at 4 months if you can avoid it and earlier than 2.5 months isn't wise either.
2. We have heard remarkably consistent reports from parents who did
gently sleep train (i.e., not CIO methods, more like "no-cry sleep
solutions") at this window with great success. Although I personally
didn't feel comfortable doing any kind of sleep training with my boys
at
this age (especially since they were 4 weeks premature and I had "issues", let's just say…), I strongly
feel that it's important to provide the developmental
information
and let parents make the decisions for themselves.
3. I think it's important to consider the unique properties of each developmental stage and think about whether there are some special considerations that should be made in terms of methods that might work best. From my perspective, I'd like to emphasize that whatever method is used
during this period, it shouldn't result in letting the baby cry for
more than 5-10 min max (I don't know about your baby, but mine cried
more than that if they were in their carseat and I stopped at a red
light). This is the only age at which I'm careful to dissuade parents
from picking a method that will involve prolonged distress because
the baby is simply biologically incapable of regulating intense distress by herself; she
needs mom and/or dad to bring her back down (of course, some babies DO calm themselves down at this age, but very few can do so when they are really, really wailing).

If you find that your baby doesn't take to sleep training easily during this age, and you feel you need to stop, then there ARE things you can do to maximize your own sleep. Some common suggestions: (1) Enlist your partner to take half the night shift and you do the other half. So, if you're breastfeeding, you can consider pumping or supplementing with formula and asking your partner to take the 10 pm – 2 am shift and you can take over for the 2 am – 7 am shift. That way, each of you are at least getting a 5-hour chunk of sleep in a row. (2) Hire a "mommy's helper" if you can afford it. This person can help soothe your baby to sleep after you feed her during the day and maximize nap times for you. She can also take your baby for a walk while you catch a nap. (3) Every 3 days or so, you can ask your partner to take the full night shift so you can catch up. Again, your partner can give the baby a bottle of breastmilk or formula when the baby wakes up. That way, you can always refuel twice a week and feel just a little more human. (4) If you can afford it, night doulas or night nurses that come very highly recommended can be serious life-savers when your partner can't help. Hiring someone even once/week might just give you enough energy to get you through the worst of this time. (5) Some people also find that co-sleeping during the worst of the frequent wakings works for them. It really DOES come to an end eventually and although 6 months seems completely impossible to imagine getting to at this point, your baby WILL get to that stage when sleep training may take much easier (believe me, I really DO get it, having had twin babies who woke up every other hour — and NOT the same hour — througout the first 6 months, I feel your horror like I was there yesterday).

What do you
think? Words of encouragement or wisdom for N.? Anyone out there who sleep-trained during this age and was
thrilled with the results (I know you're out there because I've talked
to many of you)? Does anyone want to respectfully gasp in horror at my
recommendation to try sleep training at this age?

There are so many mixed feelings about sleep training (guilt, strident confidence, defensiveness, desperation, resignation, and so on) and I think, in part, it's a reflection of more general parenting philosophies. There are some of us that started out thinking that we'd be exceptionally responsive to our baby's needs and we'd give up taking care of ourselves for the privilege of taking care of an innocent baby. There are others of us who vowed to keep our own personal and professional lives while making reasonable compromises for our new baby. And still some of us went into this parenting thing with no clue that we'd have any "parenting philosophy" whatsoever until we saw that horrid woman with her sweet child and she… <you fill in the blank>. Somehow, many of us become so wildly committed to the paths that we chose explicitly or stumbled upon. Despite the wildly controversial issues that parents (mostly mothers) feel compelled to fight for (breast or bottle, daycare or SAH, CIO or co-sleep), the truth is that not much of it makes a reliable difference in the futures of our children. Short of flat-out abuse, neglect and SERIOUS conflict in the family context, most parenting is "good enough." And I for one am so grateful for that empirical fact.

I recently received the following question from a reader:

My short response is: you're doing everything right, your baby is following very normal sleep patterns, and I hope that the 4-month sleep transition doesn't make things harder. This really is a description of the average sleep pattern many 3.5 month olds experience. In response to the main question about whether there are benefits to sleep training (and not merely the lack of detrimental effects), no, there is no well-designed study that can answer your question. But researchers and consumers of research can use the data as they like. So… yes, good sleep has been consistently associated with better performance on complex problem-solving tasks, better memory, improved mood (decreased risk of depression) and better physical reflexes. But many babies suck at sleeping and this "suckiness" has NOT been proven to be associated with long-term negative outcomes. More to the point of the reader's question, being a "well trained" sleeper as a baby has not been shown to lead to any BETTER outcomes. That's because it is almost impossible to design the right study to answer this question rigorously. I'll save you the research methodology course that I suffered through, but suffice it to say that to really establish that there are actual long-term, IMPORTANT benefits to having been sleep-trained, you'd have to randomly assign parents to either sleep train their child or not, no matter their actual parenting philosophy, their own upbringing, their child's temperament, the amount of support they had in their lives, the necessity for parents to go back to work early in the child's life, and so on. In short, there's no ethical way to run such a study. So… what we're stuck with is a bunch of studies that look at some families that DO sleep train and some that DON'T. And guess what? These families don't only differ on whether they sleep trained or not. They differ on all the other variables that I just mentioned: parenting philosophy, family history, support, family structure, child temperament, and so on. And those factors have a complex, interactive effect on child outcomes. Some children's temperaments are easier than others and this makes some children easier to sleep train for some parents. For other parents, they don't feel the need to sleep train these children with easier temperaments. Both families and children fair well. You can see the problem when you then add all the other variables that I mentioned. In short, there's no ethical way to do this kind of science to answer the question absolutely.

So… what we do know is being a sensitive, responsive parent while at the same time setting reasonable limits matters for the long-term developmental outcomes of our children. So does being personally happy, emotionally resilient, financially secure, and happily married (or in a secure, non-conflictual relationship). And if we're none of those things, if we're financially stressed, a single mom, bouncing back and forth between depression and "ok-ness", we are STILL likely to bring up our children to be thoughtful, loving, resilient, motivated, successful adults. All the research I have read (way too much to link to here, but see the books I reference in the sidebar), reviewed, and conducted myself has led me and many others to the same general conclusion: We need to screw up BIG TIME to really put our children at serious risk for long-term negative outcomes. Oh, and BTW, we can also do everything "right" and still have children who take drugs, have unsafe sex, get arrested or end up sad and lonely at the end of their life.

Sleep training matters in the day-to-day way that parenting always matters. But we're all trying to do our best, working with what instincts we have and compensating for what we don't with as much reading and surfing the web as we can fit in. Most of us will muddle through because we care enough to do our best (yes, it sounds like a commercial and I am SO cheesy sometimes). And chances are, our kids will be just fine, no matter if we Ferberize, co-sleep, CIO, use "no-cry" strategies, or say to hell with all of this sleep training.