Some thoughts about sleep-training methods

If you've been following this blog or have read our book, you know that I am extremely agnostic about what sleep-training technique works best. I simply don't think there is one best method. I've tried to convey my belief that the age and stage you choose to teach your young child to sleep is just as important as the method you use. Perhaps more important. But deciding on what method to use is indeed a critical decision as well—a very personal and powerfully emotional decision at that. I wonder if my responses to some of the questions I've posted feel somewhat unsatisfying to you. I can see why they may, given that I don't think I can offer you a step-by-step guide to changing your baby or toddler's sleep habits. Actually, I probably COULD provide that kind of specific advice, but it would mean that we'd have to go out for a long lunch and talk about your personal situation at length (maybe dinner and a bottle of wine would be more appropriate).

I think the method you choose will and should have everything to do with your parenting philosophy, the way you were parented yourself, your cultural background, whether you have to work outside the home, whether you have support from family and friends, the extent to which your partner is involved with co-parenting, whether you have a partner at all, not to mention your child's temperament and his or her already-established sleeping patterns. It's complex, isn't it? I think if I offered you a 2-paragraph summary of what you should do with your child to change his sleep schedule based on one email, I would be hugely underestimating all these other complexities that should go into your decision. But I think hearing from a whole bunch of parents going through similar struggles and hearing what worked and didn't for them (and why) is really helpful.

Ideally, there should be strong empirical support for at least one of the many methods out there but, in fact, this area of research is rather dismal. I'll point you again to the recent review of the most popular sleep-training methods conducted by the American Academy of Sleep Medicine (published in 2006 in the journal, Sleep). The review concluded that no sleep-training method is superior to any other, in terms of effectiveness. From a scientific perspective, there’s no one best way to do it. (I only make one exception to my general rule of being open-minded to any approach out there: I abhor Ezzo. I know some people swear by him. But he has contributed to some serious damage and that's why you won't see any links to his books and material here).

Despite raging debates, most authors of sleep-training books share the goal of providing children with warm, relaxing rituals that will make it easy for children to want to go to sleep. Most think bedtime should be a time for parents and children to feel close and secure with one another. Almost all the sleep-training manuals out there advise parents to first and foremost set up regular bedtime rituals that will reliably signal the baby or toddler that it is time to go to sleep. Most of these rituals include some variation of feeding the baby (either nursing or bottle-feeding), giving a warm, soothing bath, perhaps reading a bedtime story or two, singing or playing lullabies, and then finally putting the child down in his or her crib (or family bed). The methods begin to diverge at this point.

So, although I'm not going to be telling you what to do as much as WHEN to do it (and why), I'm interested in YOUR perspectives and also your questions about the methods that are out there. I'd really like to hear from you and I'd like other parents who read this blog to hear from each other:

1. Is there something you want to know about a particular sleep-training technique? I can't promise to know everything about all the approaches out there, but if I have the information, I'll share it with you.
2. What are you trying right now, with varying degrees of success or failure?
3. What method would you recommend to only your worst enemy?
4. Do you even believe in ONE AND ONLY ONE method for sleep training?

11 thoughts on “Some thoughts about sleep-training methods

  1. I’ve been reading about sleep ever since E came home and he just turned One last week! We didn’t get into a real bedtime routine until he was maybe 6 months (bath, pjs, nurse, quiet time/book). And until he was 10-11 months, he slept in a cosleeper attached to our bed. Now that we put him down in his crib, here’s what our routine looks like.
    Bath, pjs, nurse, brush teeth, see sleepy signs, upstairs to be rocked until he’s super sleepy, laid down in crib with pacifier (which I really tried to not use, but he had other ideas). Sometimes we can lay him down when he’s just drowsy, sometimes not. Usually he’s down between 7-8pm. If he cries we’ll go to him and pat his bum, and it usually does the trick. We hit the sack around 9pm, and usually like clockwork he’ll wake up around 9:30 when I’m just about in La-la-land. At that point hubby is dead to the world, and I’m exhausted, so he comes into bed with us.
    I feel like we’re not really sleep training, but rather taking the easy way out. But, all of us are getting enough sleep and E wakes up with a huge smile on his face. Part of me wonders if I’m creating a sleep monster, or if we can make co-sleeping work until he’s magically ready for a big boy bed.
    I’m positive I couldn’t endure any of the cry-it-out techniques. I’ll admit that I enjoy Dr.Sears (hence the cosleeping), but the No Cry Sleep Solution had a lot of techniques we already use.
    Anyway, that’s my 2 cents worth…

  2. @Judy: SOunds like you found what works for your family! Many people make co-sleeping work. And then sometimes it just doesn’t anymore. And then they change things up. I wouldn’t worry too much about creating any kind of sleep monster. There are PLENTY of kids who co-slept early on who grew up to be easy, independent little sleepers eventually. On the other hand, if your child ends up being one of those kids who uses the bed and mama as a trampoline from 2 – 5 am for weeks on end, you might end up wanting to shift things around and Pantley’s gentle solutions are a great way to do that for some kids and families.

  3. My son will be 9 months old in a few days. We have never tried any sort of formal sleep training although we definitely have a bedtime routine. He falls asleep easily at night but it’s the night wakings we tend to have more of an issue with.
    He has always been on the earlier side of developmental milestones and they greatly impact how he sleeps. Every time he is in between milestones (whether cognitive or physical) he is a great sleeper. Because of this we’re definitely willing to wait it out at least a full year if not longer to implement a specific sleep training method and only if we really feel like it is necessary.

  4. 1. Can’t think of anything right now…
    2. We are co-sleeping in an attempt to avoid having to do CIO. My daughter seems to be daring us to do CIO by resisting all of our pathetic attempts at other methods. She’s almost 9 months, has wicked separaton anxiety and mommy attachment, is taking 2 30-45 minutes naps during the day and waking up 2x per night for a bottle. After the first waking we can sometimes get her back asleep in her crib but after the second one it’s usually co-sleeping or nothing. At 3-4 am our willpower to resist her is nonexistent. But I hate co-sleeping because I can’t sleep well. I am waking up every 15-30 minutes worried that she’ll wake up and manage to fall off the bed onto our hardwood floors (long story, but because of our dogs, laying down padding is not an option). I hope this phase ends soon.
    3. I wouldn’t recommend CIO.
    4. No, but CIO doesn’t feel right to me. My sources are Sears and Pantley.

  5. 1. Is there something you want to know about a particular sleep-training technique? I can’t promise to know everything about all the approaches out there, but if I have the information, I’ll share it with you.
    Not at the moment. I was a fan of Pantley and then switched over to Ferber when our progress with the no-cry solutions stalled right around a year. I now think that Pantley and Ferber’s work taken together provide a pretty balanced explanation of options and ideas.
    2. What are you trying right now, with varying degrees of success or failure?
    Honestly, at this point, we are working on making bed time a little smoother. My 26 month old sleeps through the night pretty reliably, but has really needed a lot of mommy time just after her dad lays her in her bed. We’re working on phasing that back out, but it’s a tough struggle. She’s in the midst of giving up her nap, so she’s over tired a lot right now. I think just giving this some time might be the answer because sooner or later she will finish that transition to no nap and hopefully sleep more easily and a little longer at night as a result.
    3. What method would you recommend to only your worst enemy?
    I don’t know, I feel pretty bad for their kid already. I probably would just keep my mouth shut about sleep and let them figure it out without any help. That’d show them.
    4. Do you even believe in ONE AND ONLY ONE method for sleep training?
    Not really, although I think it’s important not to get too tied to CIO. We did that and it worked. However, now when our daughter cries, my husband is inclined to just let her go on and on if she’s in her crib (he’s otherwise very attentive and sensitive to her.) At this point her sleep has been good with occasional bad nights for months. My feeling is it’s not sleep training if it isn’t addressing an on-going problem. Once the child is sleeping pretty well, you have to go back to being a little flexible and trying to figure out what’s wrong if they freak out in the crib.

  6. 1. Is there something you want to know about a particular sleep-training technique? I can’t promise to know everything about all the approaches out there, but if I have the information, I’ll share it with you.
    I’m more interested in what you’ve said about there be little-to-no data on whether CIO or CIO-like methods are actually “damaging.” I feel … wrong… doing it with a very young child (6 months), but it worked wonders when my (now-2.5-yo) son was 16 months, and again (yes, again!) at 19 months. And again at … 2.5!
    2. What are you trying right now, with varying degrees of success or failure?
    Right now everybody sleeps tolerably (i.e., there’s nothing we’re trying to change), but I’m thinking about nudging my 6-month-old into sleeping a LITTLE longer in the first stretch of the night. But I might get lazy about it and wait until the next window.
    3. What method would you recommend to only your worst enemy?
    The do-not-enter between 7:00PM and 7:00AM theory. GOD that sounds awful. Moreso for the child, I suppose, and the child is not my enemy, so… yeah.
    4. Do you even believe in ONE AND ONLY ONE method for sleep training?
    No way. I say you do what works. I started with Pantley and established a bedtime routine for my first son at about 9 or 10 months where we had him in bed and asleep before 8:00 (dinner, bath, bottle, lie on couch with mommy/daddy until asleep). Then VERY SLOWLY worked up to a modified Ferber at 16 months to get him to fall asleep on his own. He’s a pretty good sleeper now, except he seems to need to be near me while he falls asleep. (Thankfully not ON me, just in the doorway of whatever room I happen to be in. Which is irritating, but, as I said before, tolerable.) Our routine at 2.5 is dinner, bath, two books, three songs, good night. I think you also need to morph the routine as the child grows to fit with their (and your) personality.

  7. @E: I get where you’re coming from with the combo of Ferber and Pantley. I lean that way myself. For me, I loved where Pantley was coming from, but in practice, the techniques didn’t quite work with my kids (for various reasons, some of which have to do with the nature of having twins). I do think that Ferber has a terrible rap with a lot of folks who haven’t read him. And yeah, that phasing out of the nap phase is brutal and can last FOREVER (we’re in it now too). Oh! And I LOVE your last comment about getting attached to CIO methods. Sometimes it seems it works miracles for some kids at some perfect moment in their life and then it’s assumed that it’ll work the same at ALL. OTHER. AGES. That’s honestly one of the main reasons we wrote the book, because development DOES matter and the same strategies won’t work the same way at different ages, especially CIO. Also… I agree whole-heartedly about your point that once the child is sleep-trained (or generally sleeping well throughout the night), then when the DO cry or ask for help, you know it’s for real — they really DO need you. Just because you’ve sleep-trained doesn’t mean you stop being responsive to your child’s needs at night. This may be a post unto itself actually. Because I think that one of the big advantages of sleep training children is that once you know they’re grooving through the night, any disruptions in that sleeping pattern means that there well and truly is something bothering them and you can feel totally confident about addressing those needs because it’s not just like every other night.
    @Jessica: I will definitely put it on my to-do list to post about the evidence that letting children cry, even at a relatively young age like 6 months, has no detrimental impact on the child’s development (there’s actually some funky, reliable data suggesting the opposite pattern). There’s a pretty good body of evidence at this point. But I hear you about it feeling “wrong.” For me, my kids were crying anyway, albeit in my arms, when I was trying to put them to sleep. So, I quickly realized that they ended up crying far LESS when I was sleep-training and afterwards compared to the weeks and months when I was doing nothing but TRYING to soothe them and “be with them.” But somehow it felt better to me to let them cry in my arms than to let them cry in their cribs “alone.” And I totally agree with “morphing” the method/routine to match your child’s personality and age.

  8. Bella, (This is E) it’s nice we agree. Now if I can just get posting to work reliably, maybe we can have some real good conversations on your blog. We’ll see what happens with this post.

  9. I tend to read any and every sleep book I come across, regardless of what I end up using, so just hearing about what people are doing is helpful. I think I like the fact that you don’t discuss actual methods on this, though.
    We’ve been more or less a CIO family. With the kid, we followed Weissbluth, because it made sense to us. It was hard, but he responded to it so well that we were able to stick with it. While we were Sears/Spock for almost everything else, we really couldn’t do the co-sleeping or always carrying in a sling to sleep thing. We’d had him on a routine and a bedtime ritual since he was 2 months old, which may be why it was so successful. When he got older and more stubborn, we switched to the Sleep Lady method. Two years later, if he’s having trouble sleeping, just shushing from across the room soothes him.
    So with this history, we thought we would do the same for kidlet. Except he slept badly from day 1 – so we tried the Baby Whisperer. I utterly hated that. It wasn’t E.A.S.Y – it was H.A.R.D (yes, this isn’t original) so we abandoned it. We then went to Weissbluth the second he was old enough and that worked for nights. But his naps continue to be poor, and since I work, I can’t nap train. No nap method other than rock till he zonks out and then put him in crib. I need to figure out what to do. I read Pantley, and I loved her – but like one of the commenters said, her stuff didn’t work with kidlet at all.
    I think Baby Whisperer sounds amazing and that it would work – but I would never recommend it. I was doing it about the same time as four other friends and we all had a hard time with it.
    With the kid, I thought Weissbluth was the only way to go. With kidlet, I’ve mellowed out. I understand that other methods can work just as well, but I still do have a tendency to lean towards Weissbluth. The Sleep Lady seems to have a liking for Weissbluth, too, so it’s a complementary method.

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