Dr. Sarah Mitchell
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Sleep Training Techniques Defined

It is a topic that could turn a friendly baby playdate into a heated discussion.  It’s not circumcision, it’s not vaccine debates…. it is baby sleep training methods or techniques

You’ve been on the internet doing some research, maybe you’ve read my blog about the 4 Month Sleep Regression and realize why your baby is waking up so much at night or isn’t a good napper.

You have identified your baby’s “sleep crutch”, that thing that she needs to help her fall asleep, and why she wakes up crying about every 3 hours at night or after 45 minutes into a nap.  Maybe it is nursing to drowsy, bottle feeding to drowsy, the pacifier, rocking, being held, sleeping on or beside you.  A sleep crutch is anything that helps her relax so she can fall asleep.

Now you need to decide what techniques you are going to use to help you teach your baby to sleep.  

I much prefer to call it “teaching your baby to sleep” rather than “sleep training”.  Really what you are doing is helping them learn how to relax.  It is not like you are training them to take their dish from the table after a meal or put their dirty clothes in the hamper.  

They really are leaning a new skill, and you are their teacher.  In addition, we have actually already trained them to sleep those first few months when we used the boob, the pacifier, or rocking to get them to sleep.  Now we are actually doing “re-training”!

Sleep training techniques exist on a continuum.  People hear “sleep training” and they think it is synonymous with “CIO” or “cry it out”.  This is a pet peeve of mine because they are not the same.  

CIO or Extinction

CIO means “extinction”.  It means to close the door and not return.  The baby cries until they fall asleep.

This technique is on the far right of my continuum.  I do not promote CIO because I try to see the world from the eyes of a child, and I can imagine that if I was that baby, I would need to know that I had been heard and reassured that someone is hearing me.

While CIO extinction can be effective for some parents, particularly with naps, there is always a small risk that you can trigger some separation anxiety from your child, and decrease their trust in you.  On the flip side, it works the fastest of all techniques.  CIO or extinction is best suited for babies 10 months and older, and parents who need fast results.

The No Cry Sleep Solution

On the complete opposite end of the spectrum is The No Cry Sleep Solution by Elizabeth Pantley. This is a technique, where you are very very slowly weaning your baby off of a sleep crutch.  I’m not a fan of this approach as I find it takes a very long time to see results and requires a parent to be extremely patient over weeks.  I usually see people who have tried that approach without success.

In addition, how realistic is it to have a baby who doesn’t cry when they are learning something new? Any time a child is learning something new there are bound to be challenges, and a baby will express that with tears.  The No Cry Sleep Solution is best suited for parents with far far more patience that me, who are terrified of tears.

Let’s keep moving along the continuum.

The Pick Up Put Down Method

This is a gentle technique.  Tracy Hoagg coined two important terms, “Pick up, Put Down” and “Dreamfeed”. Basically with her PU/PD (pick up, put down) technique you are picking your baby up when they are crying, and then putting them down when they stop crying.  The minute they cry, you pick them back up.

The idea is that you are reassuring them that you are present, but not holding them long enough that they are using you as a sleep crutch to relax into sleep.  The PU/PD  method allows parents to be present and provide reassurance.  The con is that it can take a very long time, ie., many hours at a go,   and requires immense amount of patience from a fatigued parent.

The other thing I don’t like about this book is that she indicates that a 4 month old baby should be able to stay awake for 2 hours and then nap for 2 hours.  I have yet to meet a baby who can consistently meet those benchmarks, this will set you up to fail.  In addition, I find this book hard to read as it is poorly organized and has lots of other information not pertaining to sleep.

What I do like about this book is the “Dreamfeed”, which is a term she coined to represent the action of going into your sleeping baby’s room while they are still asleep, and picking them up and feeding them. You can read more about dreamfeeding in this blog post

The Sleep Lady Shuffle

Created by Kim West, this is also a gentle techniques.  In this approach you are in the room with your little one verbally ssshhh ing them and touching them.  Over the course of a few nights, you move further and further away from the crib until eventually you place baby in the crib and walk out.

This is a great technique and is best suited for children under 9 months of age.  As they get older many children are stimulated rather than soothed by their parents presence.  This technique is well suited for attachment parenting and those who want to be nearby their child.  Overall I have found this book to be the most helpful.  It has theoretical information and practical implementation.

Healthy Sleep Habits, Happy Child by Dr. Marc Weissbluth

Dr. Weissbluth is a well-known physician. She has a book about sleep and parenting.  He gives many good guidelines, such as the 9:00 am and 1:00 pm windows for sleep in older babies. However, I found this book to have a lot of theory and not a lot of practical steps for unsure parents, however it may have been updated since I read it.

There is one tenet of his that I follow.  He says that sleeping through the night, STTN, is a 10-12 hour period, and that for a child to sleep that long, they need to be greater than 6 months of age, and have solids well established, as in 3 meals per day.  I have found this to be true with most kids.

The Sleep Sense Program by Dana Obelman

This program has a “stay in the room method” and a “leave and check” sleep training method.   I like the different case studies that she gives in this ebook, and that there are two methods to follow depending on your comfort level.  However it is lacking in other information regarding naps, and awake times for children in different age groups.

This program encourages parents with babies who are 3 months of age and 13 lbs to get their babies to sleep through the night.  I’m not sure if her definition of sleeping through the night is 6 hours, or 10-11 hours.  Either way, I find these guidelines a little ambitious personally.  In my experience breastfed babies generally need 2 night feeds at 4 months, and then 1-2 feeds at 5 and 6 months of age, over the 10-12 hour stretch of sleep.  Formula formula fed babies reaching these milestones more quickly.

Solve your Child’s Sleep Problems by Dr. Ferber

This is an interval method where you leave the room and then check back in on your child.  The first interval on the first night starts with 3 minutes, then 5 minutes, then  7 minutes , 11 and 15 minute checks.  The first check is longer each night and the period between checks gets longer with each night.

This book is thick, and has alot of scientific information and theory about sleep.  I basically focused in on about 4 pages when I used this method with my son.  The few pages that I focused in on are good in that it gives you specific instructions to follow.  However it is lacking in other information regarding naps, and awake times for children in different age groups.

The key to sleep training is to be consistent with the message you are giving your baby about how and when sleep happens at every sleep opportunity.

With any sleep teaching, you start with bedtime first and then naps the next day.  It is easier for babies to learn at bedtime versus naps.  Naps improve a little more slowly than night time since there is more daylight and more stimulation.

Summary

These are the most common baby sleep training methods or techniques in a nutshell.  The thing to remember about sleep training is to have a plan. Get support from your spouse and have 3- 5 days where you can stick close to home to set your baby up for success.  More important tips on sleep training 10 Things You Need to Know About Teaching Your Baby to Sleep.

PS.  Do you want to know my preferred baby sleep training methods? Download my Sleep Training Technique Cheat Sheet that shares with you the two techniques I prefer and why.  

If your’re thinking about sleep training. I can teach you everything you need to know inside of Helping Babies Sleep School.

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