Sleep training could benefit some babies - and their parents
For Jamie Windt, emotional turbulence arrived every evening between 5 and 7. Her infant daughter, Avery, spent the two hours screaming and crying. Finally, when Avery did drift off to sleep - often only while resting on Windt's chest - she would wake up crying whenever her mom tried to put her down in her crib.
The whole process proved exhausting.
Then she learned about Patti Ideran, a pediatric occupational therapist nicknamed "The Baby Whisperer," and she asked her pediatrician for a referral.
Ideran, who works at Northwestern Medicine Central DuPage Hospital in suburban Chicago, helped Windt begin a diary of her baby's day, including her sleeping and napping habits. She taught her how to keep track of Avery's awake times and look for cues - such as eye rubbing or putting a hand in the mouth - indicating that the baby felt drowsy. Within a few weeks, Avery began soothing herself to sleep, and Windt no longer experienced two hours of worry in the evenings.
"Avery has been a different kid ever since," says Windt, 35, of Addison, Ill., adding that her daughter, now 10 months old, was born five weeks premature.
But not everyone needs a baby whisperer to train their child to sleep. Even Ideran, who also co-wrote a book called "The CALM Baby Method: Solutions for Fussy Days and Sleepless Nights," tells parents to "know that you can do it. It might take a while, but it's a short-term consequence for a long-term gain."
Sleep training, which has been going on in some form through much of history, is still a relevant part of a baby's (and a parent's) growth. Many infants do not need to be trained to fall asleep, but some may benefit from it.
Studies have shown that behavioral interventions such as sleep training are effective in helping babies get more sleep. They also help improve maternal mood, with "patients with the lowest baseline depression scores" benefiting the most, a small study of 235 infants showed.
The pandemic and its influence on parents' work hours, plus the capacity for some of them to work from home, may have caused some parents to start sleep training later than if they had a long morning commute, but the basics of effective sleep training remain, pediatric sleep experts say.
Jodi Mindell, chair of the Pediatric Sleep Council, says when it comes to sleep training, it's important for parents to understand that the mechanism behind different methods is the same.
"You are teaching and encouraging your baby to be able to self-soothe and fall asleep independently," says Mindell, who is also associate director of the Sleep Center at Children's Hospital of Philadelphia. "The difference across the methods is how quickly or slowly you do it."
Erin Leichman, a senior research psychologist at St. Joseph's University in Philadelphia, adds that sleep training also includes the baby's ability to fall back asleep on their own after waking up.
"This can lead to longer stretches of sleep for everyone," she says.
The proliferation of apps and social media platforms over the past decade has caused parents to sift through more information and opinions than before about sleep training, but experts say to rely on your baby's cues and experiment until you find a bedtime rhythm that works for your family.
"There are way too many gadgets out there that are promising that your baby will sleep well when it's really all about the basics of a set bedtime routine and falling asleep independently," Mindell says.
Sleep experts such as Mindell, along with parents who have just undergone the sleep training process, say these things are key when it comes to sleep training your baby:
- Be emotionally ready. Sleep training for babies typically can begin around ages 4 to 6 months, after they are ready to eliminate nighttime feedings, but parents also need to prepare themselves.
Experts say most effective approaches to sleep training require some amount of fussiness or crying from the baby, so caregivers need to agree on parameters such as not rushing to pick up the baby as soon as they begin crying.
"If you leave a baby to cry for 30 minutes and then go in and save him, all you've done is teach him to cry for 30 minutes," Mindell says. "You need to be confident and ready."
Erin Thomas-Walker, 38, of Elmhurst, Ill., says she purposely sleep-trained her three children, the youngest of whom is 1-year-old, when her husband traveled for work because she knew she could handle the crying.
With each round of sleep training, Thomas-Walker put her babies in their cribs, grabbed the baby monitor to make sure they were doing okay and let the babies cry themselves to sleep.
"Something's going to give or I'm just going to drop,'' she said she remembers thinking, adding that after sleep training, "I remember being relieved."
Maddie Schoell, 31, of Montgomery, Ill., said that as she sleep-trained her baby, Ivy, she used a gradual process of letting her cry for a few minutes before going in to pat her.
"I even told Ivy what the plan was," Schoell says. She said she told Ivy that "'I'm laying you down now, I love you.' I'm not sure if it helped her really, but it helped me."
- Try one approach at a time. Be consistent. If you plan on letting your baby cry herself to sleep, stick with it for at least seven to 10 days in a row, says Mindell, instead of changing to a different method if it doesn't work after one or two nights. If you do decide to change approaches, Ideran says to allow a two-week break before trying something else so your baby and you can reset.
- Know that sleep training is not a linear progression. "It's important to realize that sleep is always changing - and that is totally normal," says Leichman, who's also the executive director of the Pediatric Sleep Council, adding that she would rather reframe terms such as "sleep regression" as "developmental progression." "Sleep patterns are always changing and can be affected by many things such as schedule changes, typical developmental milestones, or something like feeling sick or having a cold."
Schoell says Ivy, now 7 months old, had been sleep-trained when Ivy caught a bad cold. She and her husband held Ivy in their arms and let her fall asleep for a half-hour before laying her down in her crib.
"We knew it would be temporary, so we weren't too worried about it," Schoell says. "We did whatever our baby girl needed to help her feel better."
As Ivy got well, the Schoells went back to putting her down in her crib while she was drowsy but awake. She fell asleep within five minutes.
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While pediatric sleep experts agree the mechanisms and goals of sleep training center on teaching your child to fall asleep independently, sleep methods fall broadly into the following categories:
- Cry it out: Feed and burp your baby, make sure their diaper isn't wet or dirty, put your baby in the crib awake, grab a baby monitor, shut the door and let your baby cry themselves to sleep. While this might be the most emotionally difficult for parents because of the extensive amount of crying, Ideran points to a study done two years ago in the United Kingdom showing no adverse effects in attachment between babies and their caretakers or in the behavioral development of babies as a result of this method.
- Ferber method: This decades-old approach, developed by Richard Ferber, founder and former director of the Sleep Center at Boston Children's Hospital, is similar to the cry-it-out method. However, instead of leaving your baby to cry themselves to sleep, the approach instructs parents to, if their babies are crying in their cribs, enter the room at various intervals to pat their baby and reassure them (without picking them up).
- Camping out: Stay in the room with your baby, setting up a chair or mattress where you can touch or soothe your baby until they fall asleep. As your baby becomes more accustomed to falling asleep in the crib, reduce the amount of touching. Then, put more distance between you and your baby until your baby can fall asleep without you being in the room. This gradual approach works best for highly anxious babies, according to the Pediatric Sleep Council.
- Pick up/put down: If your baby begins to cry after you put her down in her crib, pick her up and comfort her until she calms down. Put her back in her crib, and if she fusses and cries again, go back and hold or rock her until she stops. While this method can take a long time to work, it can also reduce emotional angst among babies and their parents.
Whatever method a parent decides to try, they should know there will be an end to the stress and sleep deprivation.
"I just want to tell parents that it can be done," Thomas-Walker says. "You just have to be patient with yourself and your baby."
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