in ,

Everything you need to know about sleep training

I’ve been delaying writing about sleep training until I, myself, have mastered the science of getting my baby to sleep. We’ve successfully managed to get our 15-month-old year old to go to sleep with minimal intervention on our parts, so I finally feel ready to write about it.

First, let me start off by saying that infant sleep research is a black hole. There is basically no decent research that would allow ANYONE to draw conclusions about what method of sleep training, if any, is best (i.e., most effective and best for developmental outcomes). This means that there isn’t enough research on the topic of infant sleep training to warrant anyone, even people who say they are experts, to tell you what is best for getting your angel to sleep. In fact, the people who purport to be experts in infant sleep are usually physicians who tout either behaviorism (e.g., Dr. Ferber) or “attachment parenting” (e.g., Dr. Sears; also see my plea to stop using the term “attachment parenting”).

How do I know that sleep training is a research black hole? I’ve spent hours of my life searching the primary research literature. So, then, how is it that I feel qualified to write about sleep training? Good question. Despite the paucity of research, there is a lot of good theory and research (behaviorism and attachment) on other aspects of development and behavior that we can rely on when making choices about sleep training. This theory and related research is what I used to guide my decisions.

Before I get into the various sleep training methods, let me first say that there is a direct trade-off between crying intensity and how long it takes to sleep train such that the quickest method results in snot bubbles and crying oneself into a poop/barf (babies and parents alike). I’ll cover the gamut from the gentlest method (put-down, pick-up, soothe, put-down) to the potentially most gut wrenching (i.e., extinction, as us psychologists like to call it, or “Cry It Out” for most). I’ve personally tried every fecking one of these methods, btw. In addition, I have an irritable/difficult baby. Most of you will not need the level of sleep intervention that Frankie did, and I’ll thank you in advance for not rubbing my nose in it ;).

https://www.flickr.com/photos/myglesias/
Creative Commons License
This work by https://www.flickr.com/photos/myglesias/ is licensed under a Creative Commons Attribution 4.0 International License.

We started with the 5 S’s that we learned from “The Happiest Baby on the Block.” This purchase was made after our newborn was awake for 18 hours straight. Below are the basics of the 5 S’s. You don’t have to use all of these techniques (although you might need to for the baby to sleep). Your baby might just need one or a particular combination for sleep to happen. Over time, you are also supposed to wean the baby off of needing so much intervention to sleep. Best wishes.

 

  1. Swaddle the baby (We found Woombies to be very helpful in keeping our struggling newborn swaddled).

 

  1. Side or Stomach holding. Put your hands and arms out like you are going to take communion and hold your swaddled baby nugget on his or her side or stomach (whichever baby prefers, which requires a little experimenting) with his or head in your cupped hands and body resting in between/on your forearms.

 

  1. Sway baby. This step is probably better described as gently jiggling your baby. You are trying to mimic the motions of being in the womb while momma is walking.

 

  1. Shushing. You need to mimic the sound of the womb so you either have to shush really loudly or turn on some white noise. The noise has to be pretty loud. We used to turn on the vacuum and that worked great.

 

  1. Sucking. You can put your finger in your nugget’s mouth or pop in a pacifier. Our nugget never took one, but the 5 S’s still worked (for awhile).

 

https://www.flickr.com/photos/meaganjean/
Creative Commons License
This work by https://www.flickr.com/photos/meaganjean/ is licensed under a Creative Commons Attribution 4.0 International License.

Once the little muffin is asleep, you are supposed to be able to pop baby into a swing and hours of sleep are purported to be possible. This was not my experience with my difficult baby, but I hope it is with yours.

At first, the 5 S’s were a miracle, even though the whole process took between 20 and 45 minutes, because we finally had a method for getting Frankie to sleep that didn’t involve the kid sleeping with my nipple in his mouth. Our biggest problem was that once Frankie fell asleep, he woke up 20 to 45 minutes later and would not go back to sleep. The worst part was that he would take a maximum of three naps a day AS A NEWBORN. It didn’t matter if we held him or put him in his swing. He simply took short naps. Once we accepted our fate, we were able to cope better.

When he turned four months old, he was finally of the age that most psychologists would agree that babies have the capacity to put themselves to sleep (he had basic self-regulatory capacities like finger sucking and rolling over). He was also too strong to be swaddled, and we were spending 4-5 hours a day putting him down for naps with the 5 S’s. I was going back to work in a month and that crap had to stop. We moved onto extinction, which is also known as “Cry It Out.”

Cry it Out (CIO) is the simplest and most gut-wrenching of the sleep training methods because you simply pop your kid in the crib, leave, and come back after the baby wakes up. Frankie cried for 40 minutes the first nap. The second nap, he cried for 20 minutes. The third nap, he cried for 5 minutes. Thereafter, he cried for 1-5 minutes before each nap.

Then (insert ominous background music), he learned how to pull himself to stand and the whole ship went down. He now had a new form of entertainment, but he hadn’t learned how to safely sit back down. We had to video monitor him so we could see when he’d stood up so we could put him back down. After two weeks of putting Frankie back down after he stood up, I realized that we had quietly started Ferberizing or graduated checking.

by Brandi Stupica
by Brandi Stupica

Ferberizing (aka, gradual extinction to psychologists), involves putting your kid to bed drowsy yet awake, and letting him or her cry for increasingly longer periods of time (for example: 3 min, 5 min, 10 min) until the kid finally falls asleep. When you go in and check on your kid, you are supposed to check on him or her briefly and provide only minimal comforting (read: you are not supposed to pick baby up, rock, or snuggle). You simply pat the baby on the back and say a few soothing words, then you leave. Thus, even though you checked on him or her, your baby could (and probably will) still be screaming hysterically for you when you leave.

 I do not recommend Ferberizing/graduated checking/gradual extinction because it is BS. As a psychologist, I hate this method because if you are going to use behaviorism, fixed-interval reinforcement is terrible for this situation. You’re basically teaching your kid to cry for a certain amount of time before you come back, which is more complicated than it needs to be and possibly damaging to the child. Specifically, it’s potentially damaging to the developing attachment relationship because of the time it takes to successfully Ferberize (WEEKS, PEOPLE!). By ineffectively soothing and inconsistently responding to your baby’s cries, you are potentially helping baby to become insecurely attached, which sets your kid up for a whole host of potential problems.

Additionally, Ferberizing may never work and you’ll have made baby cry to no avail. At least I can say that if you stick to CIO, it will work because your kid cannot physiologically keep crying all night and will eventually fall asleep—I swear (but you have to promise not to go in to check on the kid, which I understand can be torturous for you too).

I should note here that I never planned on Ferberizing. In fact, while pregnant, I knew I NEVER wanted to Ferberize because of how ineffective and potentially damaging this sleep training method would be based on my understanding of people and how they develop. It’s the worst of all of the sleep training methods because it results in more crying over the long haul, takes longer, and is least effective. Frankie was also almost 6 months old when I realized we’d accidentally and unsuccessfully slipped into gradual extinction, at which point, we immediately changed plans.

Our next adventure in sleep training was what I call the pick-up, comfort, put-down method. We would sing Frankie the ABCs, put him down drowsy yet awake, let him cry for 20 seconds or so, pick him up, comfort him with singing, sing the ABCs again, and put him back down. We would then repeat this until he finally gave up and fell asleep. We chose this method over CIO because at 6 months, Frankie was starting to officially become attached (i.e., clear-cut attachment phase). I didn’t want to do CIO again, because I didn’t want him thinking that we wouldn’t respond to his cries, which he literally did only when it was time to sleep.

Creative Commons License
This work by https://www.flickr.com/photos/rahego/ is licensed under a Creative Commons Attribution 4.0 International License.

The pick-up, comfort, put-down method, on the other hand, sent the message that we will effectively soothe you and respond to your cries, but you have to go to sleep, for realz. This method worked okay for a few months. Then, because Frankie really liked being sung to, it turned into a catastrophe where Frankie required 45 minutes of singing and bouncing for every single put down, even the ones at night. Mind you, he was still waking up every 2-3 hours at night. Thus, we were spending 4-5 hours a day, YET AGAIN, putting him to sleep, and we were both working full-time. We had to change plans again. Despite this method not working for our extremely persistent baby, I like this method the most because it’s the most gentle. If I could go back in time, I would have used the 5 S’s to get Frankie drowsy followed by the pick-up, comfort, put-down method from the very instant Frankie was born.

At 10 months, Frankie started walking and he also learned his first boundaries (e.g., playing in the dog’s water resulted in a time-out). Clearly, he was able to regulate his own behavior, so we went back to CIO. Before bedtime, we go through our routine: Bottle, sing the ABCs, snuggles and rocking for 10 minutes, put down, and return when he wakes up. The first nap, he cried for 40 minutes. The second nap he cried for 30 minutes. The third nap he fussed for a second. After a week, he no longer fusses or cries. HE SIMPLY GOES TO SLEEP! Everyone is much happier and the mood in our house has changed from constant dread to true enjoyment. There is no anxiety AT ALL for anyone when it comes to naps. I truly enjoy my baby all the time now, even though we are going through typical toddlerhood struggles.

Moreover, after CIO part 2, his naps are often 1-2 hours, which never happened when we used the other sleep training methods, and he started sleeping in longer chunks at night too. Specifically, once he was sleep trained he started sleeping at night 12 hours straight at least 4 times a week.

CIO was rough for the first few days, but I’m glad we did it. He’s clearly learned the valuable life-long lesson of how to get himself to fall asleep. He’s also very clearly securely attached to both parents. Believe me, I’ve scrutinized every single reunion.

I’ll end by defending CIO and arguing against some of the myths about it that are meant to make parents terrified of letting their baby cry. You’ll read on the Interwebz that humans didn’t evolve to let babies cry it out, or they would have been eaten by a lion.

I’m calling BS on this argument because it assumes that the crying baby was placed in the middle of an open field and abandoned. Highly unlikely, right? If early humans used CIO, they likely placed baby in a soft, warm basket in a warm, dark, quiet shelter, and sat nearby. If any lions came along to eat the baby (which likely is not going to happen), the group of humans scattered about the settlement would chase it off or kill it. In fact, chew on this interesting evolutionary perspective on CIO: If crying truly does attract predators, early humans might have preferred the CIO method because it brought their dinner to them.

Another sticking point I have with the CIO detractors is that they will tell you that the child will be insecurely attached. First, there’s no research to indicate that. Second, not even attachment theory outlaws CIO. As long as you are effectively and sensitively attending to your child’s signals 30-50% of the time, your child will likely be securely attached. With CIO, the 50-70% of the cries that you don’t respond to will simply be when the kid is supposed to be sleeping.

My last counter-argument to people who are militantly against sleep training: Given the lack of science on sleep training, it’s highly possible that NOT sleep training can do long-term damage to your child. Consider a situation in which your kid keeps using you as his or her way of going back to sleep and NEVER learns how to just close his or her eyes and conk out. This kid could turn into a preschooler who needs 10 midnight snacks, 17 glasses of water, 8 bathroom trips, and 98 books. This preschooler can turn into a teenager and college student who stays up until 2 am surfing the Internet, sleeping with the TV on. I have a hunch that this situation might sound very familiar to some of you.

baby-218d94One last important note before I sign off: Every baby is different. Remember when I said infant sleep research is a black hole? This applies to how much sleep babies need at various stages of their life. The Interwebz swears that newborns should be sleeping 16 hours a day, but what it doesn’t tell you is that this is on average. Thus, there is a wide range of sleep that is considered normal (11-17 hours for newborns, in fact). Your kid might have a sleep pattern that differs from the norm.

In sum: If your kid is having trouble sleeping, as soon as possible, try a soothing pre-bed routine (I recommend the 5 S’s) followed by pick-up, soothe, put-down as your first line of defense. Then, if that doesn’t work, move quickly and swiftly to CIO if your baby is younger than 6 months or older than 10 months. Lastly, make sure you have at least 3 gallons of wine in the house before you start any sleep-training regimen.

Follow Me
Brandi Stupica
Brandi Stupica, also known as Professor Parenting, started blogging after she had a baby and found her PhD in Developmental Psychology colliding head-on with real life parenting. She writes about how she uses her doctorate to help her raise a happy, healthy kid. She also writes about how she’s a real human being who sometimes lets her kid eat sugar and watch TV so that she doesn’t commit manslaughter. Follow her parenting wins and fails on her blog Professor Parenting, Facebook, Twitter and Vine
Follow Me

What do you think?

0 points
Upvote Downvote

Total votes: 0

Upvotes: 0

Upvotes percentage: 0.000000%

Downvotes: 0

Downvotes percentage: 0.000000%

2 Comments

Leave a Reply
  1. Hello-
    I really enjoyed your read. My daughter is 11 months and I feel that we’ve done a good job at getting her to sleep on her own, both naptime and nighttime. We went from her falling asleep breastfeeding/bottle feeding and laying her down to laying her down awake (drowsy or not) and having her fall asleep – or if fighting a nap so hard, she’s at least in her crib for a bit of time.

    Anyway, in the last month or two, she’s resulted to vomiting if she gets to a point where she cries so hard. So it’s become very VERY difficult for me and my husband to let her cry because she will get to the point of vomit. So in this case, when we find her getting worked up, we’ll go in and take her out for a few minutes and either give her more of her bottle or let her play for a bit and then put her back – definitely not ideal, but better than vomit & bath.

    Do you have any suggestions? This phase cannot last forever, but I also don’t want to start bad habits of “If I cry hard enough and then vomit, mommy and daddy come back.”

    Thank you.

  2. Hi Kim,

    Thanks for the question. I’m sorry about the puking. It’s heartbreaking. We’ve been there. Obviously, when your kid pukes, you have to go in and clean them up. So, you’re left with the issue of responding simply to the puke mess and putting the kid right back into the crib to continue sleep training or cleaning up the puke mess and doing the bed-routine again and getting the baby back to a good place for sleeping.

    I, personally, agree with your decision to deal with the emotional aspect of the situation for two reasons. First, after 6 months of age, the baby is laser-focused on figuring out if you are the type of parent who is generally sensitive, available, and responsive or if you are not. So, if you go in and simply clean up the puke without attending to the child’s emotional needs, you are telling the baby that his or her emotional needs are not a priority of yours. Your choice is spot on for keeping baby growing into a happy, healthy, and independent young woman.

    As for whether I think you are doing the right thing by going in right before the meltdown, I can’t say because it depends on your goals and needs as a family. Sleep training has two main goals: a) teach babies to put themselves to sleep and b) teach babies what their caregivers’ limits are with respect to sleep. If you are okay teaching your baby that you will respond and comfort her if she gets too overwhelmed, then you are doing the right thing. It’s what my husband and I do too, because babies start solidifying their attachments to their parents from 9 to 18 months, which creates the emergence and peak of separation anxiety. Thus, around 9-18 months, even if the baby was previously sleep trained, parents will have to deal with upticks in their baby’s distress at being left alone and separated from their caregivers.

    Like you, my husband and I go in when we feel like the distress is genuinely too much for Frankie to handle because it’s not an issue of teaching him to fall asleep on his own in these instances. Frankie’s already developed the capacity to put himself to sleep, so his distress, we feel, is truly an indication that he is overwhelm, so we “rescue him” so he knows that if he really is overwhelmed and needs us, we’re there.

    Thus, the problem is an attachment thing and not about the ability to put oneself to sleep. This seems to be true for you too, especially since she gets so worked up she pukes. You know your baby best and are the expert in knowing what her limits are. If she starts trying to test your limits by crying to get you to take over the responsibility of getting her to fall asleep, I’m sure you’ll notice the change and attack the issue. In the meantime, good luck and I’m sorry that you have to deal with this glitch.

Leave a Reply

Your email address will not be published. Required fields are marked *

Getting your life and family back after grief takes over