Sleep training is a controversial topic – is it realistic to expect baby to be sleep trained? What are the side effects of letting the baby cry it out? There are ways to help a baby sleep better and they need not be ‘training’. Let’s explore which the possible techniques and their key pros and cons.
For Infants below 3 months old
At this stage the newborn baby has just been birthed into a whole new world – apart from milk and sleep, the baby also needs comfort and a sense of security. Imposing a sleep routine at this point isn’t appropriate and it is best for parents to sleep when the baby does so, or to take turns with feeding at night (if feeding from bottle). It is normal for babies to wake up for a milk feed, fall asleep for a few hours and wake up again.
However, you can try to establish a bedtime routine, for instance a bath, some music and feeding before bedtime. Try to time naps at regular times of the day and not too close to bedtime. Gradually, the baby will sleep longer at night and less in the day.
For babies older than 4 months old
During this period when the baby starts to sleep longer at night, parents can start to explore techniques to help the baby develop a more regular sleep pattern with fewer night milk feeds. Parents’ expectations, however, should not be total uninterrupted sleep – each baby is different! Be sure that ‘night wakings’ are not due to a health condition and remember, sleep training should start only if your baby is healthy. Consult your doctor for advice too.
Nature has designed such that parents bond with their child and mothers have intuition on discerning babies’ cries and responding to them. Some studies have shown that mothers who force themselves to ignore their babies’ cries start to feel detached from the baby and the baby is also less likely to thrive. Likewise for sleep training, parents should go with what they feel is most natural to them and not feel compelled to adopt any training that they are not comfortable with (or which their baby is clearly resistant to and feel distressed about).
The “cry-it-out” approach
There are variations to this approach and the most well-known one is by pediatrician Richard Ferber where the belief is that babies are able to soothe themselves to sleep. Although this method is known as ‘cry-it out’, it does not mean that babies are left to cry for extended time. The approach is typically putting your baby to bed when he’s still awake and when he cries at night, to comfort him but not pick him up. The time interval for parents to intervene increases for each night until eventually, the baby can fall back asleep without parents’ help.
If it works for your baby, parents’ intervention is not necessary to help baby sleep thus parents can have more uninterrupted hours of sleep at night. This method is likely to work within a week.
It can potentially be distressing for your baby to be left alone to cry, especially if the time he is left alone is too long. It may also create arguments between parents over how long to leave the baby to cry or for how long to persist with this method.
The “no tears” approach
This approach does not favor letting the baby cry but instead prefer responding to the baby’s needs. This method is advocated by Dr William Sears who believes that there would be negative associations with sleep if babies are left to cry without comfort. The preference is to respond to the baby and from getting the trust and comfort the baby needs, the baby will grow to be more secure and not be afraid when awake at night. The baby can be put in his bed when sleepy and if he wakes up at night and cry, to hold the baby and comfort him. Parents can also discern when a cry is a cry for help and when it is simply sounds that babies make when awake. There is no need to pick up the baby if it is the latter. Putting the baby to bed when sleepy but not asleep helps the baby to gradually learn to fall asleep on his own.
Immediate comfort offered to the baby with minimal distress.
Concern on whether the baby will be over-reliant on the parents to fall asleep.
Differentiating Day and Night
This approach focuses on establishing a routine in sync with the day – baby gets up at sunrise and the natural light helps the baby to know it’s day time. The baby crib can be placed closer to window and more activities (play, meals, regular naps) planned at day time. At night, the baby recognizes it’s rest time along with dimmer lights, pajamas and bedtime routine like quiet reading and night feeds. Parents can also explore if a bath before bedtime is calming for the baby and experiment with white noise and music. Other associations with bedtime can be created with sounds such as ‘ssshhhhh’ or a bedtime song.
Help establish a 24 hour routine and the baby to set the ‘biological’ clock.
May take more time for baby to sleep on his own throughout the night.
Tuning to Sleep Rhythms
This approach tries to establish sleep patterns both for naps and at night, without the baby sleeping when overly tired. A nap and bedtime routine is set up and when the parent anticipates that the baby is getting sleepy, nap or bedtime routine should start. A baby who is sleeping well during naps is likely to sleep well at night – the key to good sleep is to sleep when the body needs it, instead of when the body is too tired.
Natural and simple as the key is predicting when the baby needs to sleep and establish a routine.
May take a longer time for the method to work.
Co-sleeping refers to either sleeping beside your baby or sharing the same bed. It is associated with reduced stress for baby, as it is comforting to sleep beside a loved one. With the baby waking up less at night or less likely to cry when the parent is beside, there is then more hours of uninterrupted sleep.
Helps with bonding and also night time nursing.
Dangerous for baby if there are hazards on the big bed or parents are not attuned to having a small baby beside them. Lack of privacy and hard to ‘wean’ the baby off co-sleeping when older.
At the end of the day, both parents and baby want a good night’s sleep. Each family can work out the method that they are most comfortable with and parents can take care not to sabotage bedtime by not having a routine, creating excitement before night or rushing to pick up the baby at the faintest sound. No family should be pressured to use any method that work for others – every family is unique!