The Basics of Sleep Training and Sleep Regression

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If getting your infant to sleep through the night sounds like a dream-come-true, sleep training might be in your future. Here are the basics of sleep training, the different methods of sleep training, and why babies go through sleep regression—and how to deal when it happens.

When I was pregnant with my first child the number of people who told me, “You will never sleep again,” was overwhelming. Cut to six years, a second child, and many sleepless nights later—though I’m sure I have actually slept—and I am, indeed, pretty darn tired.

Fatigue certainly comes with the parenting territory, especially in the first few months of bringing home your newborn. But getting consistent sleep is extremely important, not only for your baby, but for you as a parent, too. That’s why sleep training your baby once she’s a few months old—that is, teaching her to fall asleep and stay asleep on her own—is a great way to ensure everyone is well rested, and, in turn, happy.

There are several sleep-training techniques, but ultimately all of them lead to restful nights for the whole family.
    

Sleep-Training Methods Explained

You may have heard of the “Cry It Out” and “Ferberizing” sleep-training methods. Those are two of the most well-known approaches, but many different variations have been developed. Each technique involves a few (or a lot of) tears, and all differ slightly in terms of how present you are supposed to be and how much you comfort your child as he falls asleep and when he wakes up. Ingrid Prueher, founder of Ingrid Baby Sleep Whisperer and a Fox & Friends sleep expert, works with individual families to create a method that works for them, while other experts, such as Denise Stern, baby nurse, postpartum care expert, and founder of Let Mommy Sleep (an overnight, in-home, infant care service), use a practice called sleep helping. “It is a simple way to say that we very gradually increase feeding during the day while gradually decreasing feeds overnight,” Stern says. Whichever method you choose, take comfort in knowing a good night’s sleep isn’t too far off.

Here is a cheat-sheet of common sleep-training methods that may work for your family:

Cry It Out or CIO: This method involves going through a bedtime routine with your baby, then placing her in her crib, leaving the room, and not coming back until the morning—as long as your infant is safe. This will be, by far, the method that produces the most tears, although it has recently been deemed harmless by the American Academy of Pediatrics

Ferberizing: Developed by Richard Ferber, M.D., this technique is considered a gentler version of CIO. With this method, you check on your infant and console him after a few minutes of crying, increasing the amount of time between your visits to his room to check on him.

The Chair Method: Parents who practice this approach go through the normal bedtime routine, place their baby in the crib, and then sit in a chair next to the crib until she falls asleep. They do not console her with words or cuddles, only with their presence. Each night they move the chair farther and farther from the crib until they are out of the room.

The Pick Up Put Down Method or PUPD: This gentle method allows parents to pick up their crying baby, soothe him, and then place him in his crib to sleep, repeating this all night until, eventually, baby sleeps through. 

The Fading Sleep Training Method: With this technique parents continue to help their baby fall asleep by rocking or feeding. Each day they do less and less to soothe their baby in the hopes that she will begin to soothe herself. This is a great option for parents who prefer a method with less crying.

RELATED: Get Your Baby to Fall Asleep Faster and Stay Asleep Longer
    

Getting Started with Sleep Training

It’s important not to rush sleep training. For his first few months of life, tend to your baby when he cries and soothe him with feedings, diaper changes, or cuddles. Before sleep training your infant, Prueher suggests that:

  • You have approval from your pediatrician 
  • Your baby weighs close to 16 pounds
  • Your little one is close to 4 months of age. This is when a child’s biological clock forms, and you can use a biological sleep schedule as part of the process of teaching her to become an independent sleeper. 

If you can check off all three of those things, you can start sleep training your baby. “Lovingly teaching a child to sleep independently is about empowering the child to do what they have been born to do on their own. Children are born being able to sleep independently,” Prueher says. “In some cases, new parents just don’t know how to put a child to sleep and they feel their role as parents includes closing their child’s eyes for them. So, they resort to rocking, feeding to sleep, driving around, using a stroller during all sleep times.” But it doesn’t have to be that way. Babies are programmed to self-soothe; they just need a little push to get started.

One of the most important things for parents to remember before getting started is, no matter what sleep-training method is used, there will be tears. But “sleep training should never be traumatizing, produce throwing up sessions, or make you feel like you are hurting your child,” Prueher says. Creating a plan and feeling secure in it will reduce the number of tears your child (and you) may shed.

Like Prueher, Stern insists you get the “okay” from your pediatrician before starting to sleep train. Your baby needs to be able to go at least 8 hours without a feeding, and babies who were premature or who are gaining weight more slowly are not good candidates for sleep training at 4 months old. “A good rule of thumb is that when a baby is able to take in twenty-eight to thirty-two ounces between the hours of six am and ten pm, that’s usually enough to satiate them through the night, but it’s crucial to have baby’s primary care physician agree that it’s appropriate to begin sleep training,” Stern says. 

Remember: Just because you have successfully sleep trained your baby, it doesn’t mean he won’t wake up once or twice (or more) throughout the night. “It is very common for baby to have periods of wakefulness and times when they need parents’ help,” Stern says.
    

Sleep Regression Tips and Tricks

If your baby, who was successfully sleeping through the night, starts waking more often, or staying awake for an extended period of time or for what seems to be no reason, she may be experiencing sleep regression. This can throw parents for a loop and often make them feel overwhelmed in having to go back to square one.

Alice R., a Brooklyn mom, went through this when her son was 9 months old. “Ryan had been sleeping through the night since we sleep trained him at four months old,” she says. “We had five months of bliss, and then it was like we were hit with a bomb. He was waking up a few hours after being put down and nothing we did worked.” Alice says she felt desperate and contacted a sleep expert for advice. Two weeks after starting the sleep training process all over again, Ryan resumed sleeping through the night.

“The Golden Rule for regression is consistency, consistency, consistency,” Stern says. “Simply continuing the methods that your child is already familiar with is the best way to minimize regression. It’s important to remember, too, that babies are smart. If you hold them to sleep for a few nights during illness, for example, that does not mean they forgot how to sleep independently when it’s time for them to go back to sleep in the crib.”

While sleep regression may seem like it occurs out of the blue, chances are there is a very good reason your child is waking. Teething and physical milestones (sitting up, crawling, and standing), and general alertness all contribute to sleep regression.

“No matter if they are ‘good’ or ‘bad’ sleepers, all little ones will wake when they’re experiencing teething pain or illness. Babies who are just learning to crawl and stand will also have fun in the overnight hours practicing their new skills,” Stern says. “In fact, many little ones just learning to walk will pull themselves up to a standing position in the crib and then call out to mom or dad because they are ‘stuck’ in the standing position!”

If your baby is not sick, it’s okay to not rush into her room when she wakes in the middle of the night. Giving her a chance to fall asleep on her own, again, just reinforces the sleep training.

In addition to maintaining normal bedtime routines, here are simple tips to combat sleep regression:

  • Provide extra comfort at bedtime in case separation anxiety is causing your child to wake up.
  • Remove all distractions, as lights and mobiles are not so useful during a period of sleep regression.
  • Make sure the room is a comfortable temperature, between 68 and 72 degrees.
  • Don’t form new “bad” habits such as rocking your baby or bringing him into bed with you. Remember this is a short-term phase.

Each family is different, and it is important to stay in tune with your baby’s needs, as they may change. Sleep training, whichever method you choose, is a great way to maintain a happy and healthy household. “We know the benefits of sleep can help our children live happier and healthier lives, so let’s make sleep a priority,” Prueher says. “It’s the best gift you can give your child, it will reward them forever.”
    

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The mission of Allied Foundation is to impact and improve the health and well-being of residents within Allied Physicians Group’s geographical footprint, which currently includes Long Island (Nassau and Suffolk), Queens, Brooklyn, Richmond, Westchester, Rockland, and Orange. The Allied Foundation funds community-based strategies and initiatives, including Breastfeeding Support (toll-free Support Line: 866-621-2769; Breast Milk Depots), Community Education (free app—AlliedPG—and lectures about such topics as ADHD, managing food allergies, behavioral health, and infant CPR), Early Childhood Literacy (proud partner of Reach Out and Read and The BookFairies); and Community Service (Diaper Bank of Long Island). For more information, visit alliedfoundation.org.