How to sleep train

Sleep training is an effective, safe method to help a baby learn to self-soothe at night and help jump-start good sleep habits.

Sleep training is the process of teaching your child how to fall and stay asleep and self-soothe. It’s not “cry it out,” as many mistakenly assume. We will walk through what sleep training is and isn’t — and how to sleep train a child.

What is sleep training?

Anyone who has raised a child knows that the first few weeks of life bring a chaotic sleep schedule for parents and the baby. This is because babies need parental help to soothe themselves to sleep by actions such as swaddling, patting, nursing and rocking. Sleep training includes a variety of methods that help a child learn to self-soothe and fall asleep on their own.

Sleep training uses behavioral techniques that alter your child’s sleep onset associations, or what your baby needs to fall asleep at their bedtime, that allow them to sleep independently through the night.

“There is no one-size-fits-all method to the sleep training. Even in families, what works for one child may not work for another,” said Kelly L. Johnston, APRN, pediatric nurse practitioner with Norton Children’s Medical Group – Dixie. “What is most important is that families establish safe and consistent sleep habits.”

Start with chaos and develop a consistent routine

Embracing that chaotic newborn sleep schedule is really the first step in the process. By about three weeks of age, children will settle into a three- to four-hour pattern of waking, feeding and sleeping.

“During this time, exposing your child to some natural light during the day may encourage your child to be awake during the day for longer periods,” Kelly said. “Additionally, you will want to start a consistent bedtime routine that works for your family’s needs.”

A consistent bedtime routine can include actions such as giving a bath, putting on sleep clothes, reading and/or singing to the child, feeding or soothing the child, and ultimately placing them in their crib. The routine can be unique to the family, but should be simple enough that one person can complete if necessary. It’s also important that the activities are done in the same order and at the same time each day. Finding the best time to begin the routine may be difficult at first, and you may have to adjust your child’s nap schedule to find the right bedtime schedule. Each caregiver should participate in the routine, as the sleep training process can lead to caregiver burnout if only one person is able to soothe the baby or has to shoulder the entire process.

As a child gets bigger and needs fewer feedings, they can sleep for longer periods, for up to six or seven hours, throughout the night. This usually happens around 3 to 4 months of age. At this point, parents can begin putting a child to bed while the child is awake, but drowsy. If you feed or nurse your child to sleep, you may want to consider putting nursing/feeding at an earlier time slot within your bedtime routine. This may help the non-nursing parent to be able to take care of the rest of the bedtime routine.

“When you first put your child down, it’s normal for them to cry or make some noise,” Kelly said. “However, if your child sounds distressed or is crying very hard, they likely are not ready to fall asleep on their own. That’s OK; you just try again in a couple of weeks.”

It’s important that if you hear your child wake up, coo, burp or cry, to pause and wait to see how your child handles it. Your child may be able to self-soothe and fall back asleep on their own; doing so can help them learn to sleep through the night faster. If your child is having trouble falling back to sleep on their own, it is OK for you to go in and soothe them.

This process can lead into children sleeping on their own for eight to 10 hours a night by 4 to 6 months old. Children who are breastfed may need to be fed once per night until they are about 9 to 10 months old. By this time, if you’re still getting up multiple times during the night to soothe your child, you may want to consider sleep training.

Signs a baby is ready for sleep training

Your child is ready for sleeping training if they are:

  • Sleeping five to six hours or longer at night
  • Waking up often in the night after a stable period of sleep
  • 4 to 6 months old

Types of sleep training

There are two methods of sleep training: extinction and camping out.

Extinction sleep training is associated with the term “cry it out,” and the Ferber Method, a version of extinction sleep training popularized by pediatrician Dr. Richard Ferber. Extinction sleep training in its simplest form is placing your child alone on their back in the crib, drowsy but awake, and then leaving the room without returning to soothe the baby through the night. This method often creates long periods of crying for several nights, and can be tough for parents to endure their child’s prolonged cries. This method is controversial to some parents, as critics say it seems cruel or could be harmful to the child’s behavior, sleep or the relationship between the child and parent. However, equating this method to “cry it out” isn’t exactly true.

“This version of sleep training now includes periodic checks on the child, including checking on them when they cry after waiting a brief amount of time, which can be very soothing and reassuring to some children,” Kelly said. “Parents who explore a version of this method would want to adjust, depending on whether these checks are helping or hindering their child in the process.”

Studies have shown that this gentler form of extinction method does not produce the long-term effects some contend can occur. Another study showed that these checks reduced the percentage of parents reporting sleep issues five months later by about 30%.

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Camping out is the sleep training method where a parent withdraws their presence from the child’s room slowly, taking about one to two weeks. This method may be a good fit for parents who are concerned about prolonged crying. A camping-out protocol will depend on your bedtime routine and the activities you use to soothe your baby. For example, if you sing to your child, the process may look like:

  • Days 1 to 4: Stand by the crib and rub baby’s back instead of singing.
  • Days 5 to 7: Sit by the crib without touching your child.
  • Days 8 to 10: Sit in a chair halfway between the crib and the bedroom door.
  • Days 11 to 13: Sit in a chair in the doorway to the room.
  • Days 14 to 16: Sit outside the doorway, but with the door open and the child can see you.
  • Days 17 to 19: Sit out of the child’s sight but verbally reassure the child, by being outside the door or using a baby monitor.

With this method, you can talk to your child and be verbally reassuring every step of the way. If your child responds well to the method, you can move through the steps as quickly as you’d like.

However, it’s important to know that no matter the method families choose, there is no way to get away from your child crying. You will experience your child crying with any approach you choose.

“Sleep training depends on the parents and the temperament of the child,” Kelly said. “Ask your pediatrician about sleep training and what may be right for your child. Your pediatrician can help set your family up for success with sleep training so that everyone can get some rest.”


Norton Children's Medical Group

Norton Children's Medical Group – Dixie

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Norton Children’s Medical Group

Norton Children’s Medical Group, affiliated with the UofL School of Medicine, offers pediatric primary care at more than 20 locations throughout Louisville and Southern Indiana.
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