Sleep Training Methods

Are you rocking, holding, feeding, bouncing or assisting your child to sleep? Is your baby falling asleep with your help? Are you putting your baby down asleep in her crib? If so, then you have created a sleep crutch and now she can’t put herself to sleep. Sleep training or coaching is the act of behaviorally teaching your child how to put themselves to sleep and back to sleep on their own. It’s when you remove sleep crutches and teach the independent skill of self-soothing and putting yourself to sleep.

 So how do you remove those sleep crutches? How do you teach your child the independent skill of self-soothing and putting themselves to sleep? You may be saying, ‘If I stop rocking my child to sleep how will she put herself to sleep? If I put her down in the crib, she’ll cry.’ Yes, this is true. She doesn’t know how to put herself to sleep. And unfortunately, she will cry. For the younger ones, this is how they communicate. For the older ones they’ll cry and yell out “Mommy!!” But this doesn’t necessarily mean you have to leave her to cry alone. There are different methods that you can choose from that don’t always necessarily mean to leave her to cry alone.

The three main methods that are widely used across the board and that have been around for years are: extinction, gradual extinction, and parental fading. Let’s go into depth on what each of those look like.

Extinction: Extinction is what people refer to as “Cry It Out Method.” This is the one that most people talk about. In this method, the idea that Weissbluth had is to do full on extinction, meaning you place your child down awake at bedtime so that they learn how to self-soothe and put themselves to sleep, and leave him to do it on his own. So you do NOT go in at any point. You go from whatever your sleep crutch was, to full on putting him down awake, leaving him be, and he will learn how to do it on his own. So even if he cries for 15 minutes, 40 minutes, 1 hour – there is no intervention at all.

Many will argue that this is the “fastest” method to get your child sleeping, but that is not necessarily true. I will also say that this isn’t the right fit for all children, and for all parents, and that is totally OK! You don’t have to be! Honestly, when I did sleep training for my kids, I did not choose this method because I didn’t feel comfortable doing it. I knew that I wouldn’t be able to stick to it at bedtime, or the middle of the night. I knew myself and my strengths and weaknesses, and knowing that I wasn’t’ going to be consistent, meant I had to go another route. But at the same time, if you choose to do this method, that’s OK too! If it works for you and your child, then there’s nothing wrong in choosing this method.

Gradual Extinction: This is the one that many confuse with CIO. This is actual Ferber’s idea of being able to go into your child’s room to reassure him when he’s crying. But in order to do so you need to do it in timed intervals, and slowly gradually going to extinction – or not going in at all. So rather than just placing your child in the crib and not going in at all at any point, with this method, you ARE allowed to go in and reassure your child. The idea is that you wait longer and longer before you go in. So let’s say for example on that first night you put your baby down awake and leave the room. He will start crying the minute you put him down, or as soon as you leave. Now rather than like in CIO where you don’t go in and you leave him to cry, in this method you will wait a few minutes before you go in and check on him. Let’s say for example that first night you go in every 5 minutes. Well on the second night, you now need to wait longer, maybe 7 or 10 minutes before you go in and check on him. Because you can’t keep on going in every 3-5 minutes every night. You want to give your child the opportunity to learn and also self-soothe. If you keep on going in, he will continue relying on seeing you and we won’t give him the chance to do it on his own.

Parental Fading:  This is considered a more gentler approach. This allows the parent to be in the room, without leaving the child alone. So rather than leaving them to cry it out alone, or going in and out of the room, you are actually staying in the room. Assisting, helping, but of course then working on doing less and less whatever that is.

The most common one is the Sleep Lady Shuffle. In this case you are sitting in the room, but with time you are slowly moving further away. You fade away. This helps for those older kids that need to see mommy or daddy and not feel alone. This method is suggested for any baby over the age of 6 months. But I do in fact think this is a great method for those that are already sitting/standing. For those older ones that are aware whether the parent is in the room or not, standing next to your child, rather than leaving and coming back, makes a difference.

Now the most important part to this method is, is that you don’t get stuck in the room. That you don’t create a new sleep crutch. You need to make sure that you slowly remove yourself, you fade away. With this process, as you are inside the room you can talk and reassure. Even when you’re close enough you can do some touching. But as the nights go on you must make sure that you are slowly inching your way out of the room and removing yourself from the sleep space. You will eventually get to the point where you put your child down awake and completely leave and she will be OK with that.

 Remember, just like the other methods, whichever method you choose, you must do the same thing at night. You must be able to respond consistently from bedtime until the morning. Because half of seeing the success in sleep training is putting your child down awake, and the other half is consistency.

Have questions on which method is right for you? Let’s talk!

Sleep Associations: What they are and their impact on sleep

Sleep crutches, also known as sleep associations or sometimes referred to as sleep props, are anything that we do for or to our child in order to help her fall asleep at the onset of sleep.

Some examples of sleep crutches are:

• Rocking

• Feeding (both breastfeeding and bottle feeding)

• Holding your child’s hand to sleep

• Patting/rubbing her to sleep

• Laying down with the child to fall asleep at bedtime

(I do want to be very clear that if you are using a sleep crutch to get your child to sleep and it is working for you and/or your family, then this is not something that you have to change. It is only something to be changed if it is no longer working for you.)

Babies under 4-6 months often need sleep crutches

Babies are not born with the immediate ability to self-soothe and regulate themselves, this comes once they are older. In those first few months, you will need to help them do this, and by doing so you will NEED to hold, rock, feed, and anything else to get your child sleeping. This is normal and it important to do those things because this is how your baby starts to trust that if he/she needs something, you will be there.

When sleep crutches stop working

BUT…as children move past the 4-6 month mark, they start to become very capable of falling asleep independently. In many instances, these sleep crutches will stop working. This means that you may feed your baby and he/she falls asleep, but when you go to make the transfer to a sleeping space, your baby wakes up. Or, now your baby wakes after 30 or 45 minutes or every 2 hours throughout the night. Or rocking your child to sleep takes double the time. This is can be an indication that your child is starting to become capable of falling asleep independently. When this happens, you can start to teach your child how to fall asleep without the help of the sleep association.

How do you stop using sleep crutches?

This is where sleep coaching often comes in so that children can start to develop the skill of falling asleep on their own at bedtime and then use that skill repeatedly throughout the night to go back to sleep. Sleep coaching does not have to be a horrible and dreaded process. In many cases, parents can be involved in a way that is both supportive, nurturing and eye opening. Parents tell me all the time that they were amazed by the fact that they could see their child learning this new skill right in front of their eyes. 

Contact to schedule an initial call so we can talk about how to work together in removing those sleep associations, and start creating healthier sleep habits.

What you need to know about Sleep Training

This is the most common question you will get as the parent of a newborn baby: Does your child sleep through the night? It's not about her favorite toy or whether she likes to take a bath. The first thing on people's minds is whether she sleeps.

We all know that sleep is important for our health. But it’s also important for our being. We can’t be our best selves when we lack sleep. Our relationships with our spouses, with friends, and even with our own kids are compromised when we don’t sleep enough.

The problem is that our babies aren’t born sleeping through the night for 12 hours straight. As newborns, they just can’t sleep for long stretches. And that means our sleep will be broken up too.

The good news is that this doesn’t have to last very long. Once your baby is of “sleep training age” you can work on getting her sleeping better. But how? What does that mean? When? With all these questions we turn to books, internet (be careful with what you read!), friends, pediatricians and then before we know it our heads are spinning because we’ve had so many different opinions thrown at us.  

Here’s what you need to know:

1. Your child might not be ready.  Every child is different, and we can’t expect them all to develop exactly the same way; so too with sleep. Still, there are some guidelines for when you can expect to start sleep training. Anything younger than 4 months is a definite no, and anything after 6 months is a go! Between 4 and 6 months, some parents will find positive results in sleep training their child, but not all. 

2. You don’t have to stop breastfeeding to do sleep training. Many nursing moms feel that they will have to give up nursing in order to get their child sleeping longer and better. This is not true. Speaking as a mom of 3 who nursed all while still doing sleep training, it is possible! You can definitely nurse as long as you want, while doing sleep training. What we work on is removing the nursing to sleep association.

3. Is my only option to do the “Cry It Out” method? No. You do not have to do this method. What you do need to know is that your child will cry for at least part of the learning process. But you do not need to leave her crying by herself the whole night with no response from you. Instead, you can be in the room to comfort your child, while removing all sleep crutches and helping her learn how to put herself to sleep. 

4. So, what does sleep training involve?  When you sleep train your child, you are having her learn how to put herself to sleep at the onset of sleep, so she can do it again--by herself--in the middle of the night. The key is putting her down awake in her crib, and responding consistently throughout the process. If she’s already asleep when she is put down in her crib, she will not have the opportunity to learn how to put herself to sleep. And if you start responding inconsistently (leaving her to cry one time, then later picking her up, and then feeding her, etc.) this will only confuse her more and will result in inconsistent sleep behavior on her part as well.

5. What if my child still needs to feed at night?  You can still improve her sleep! It is commonly recommended to remove all night feeds starting at the age of 6 months; however, there are parents that aren’t ready to do that, and sometimes a pediatrician might recommend keeping them. That’s OK! You can still have your child sleep longer stretches, and feed when needed.

So what’s my next step?

1. Rule out any medical concerns, and get your pediatrician’s approval.

2. Make sure your child is over the age of 19 weeks (adjusted age).

3. Contact me to set up your consultation and we can begin the process!

Here’s to more sleeping babies (and parents!)

DBA... What Does It Mean? How Do I Do It?

DBA means Drowsy But Awake. If you’ve read aaalllll the sleep books and blogs out there, you know they all talk about this concept: “drowsy but awake.” In order to have your child sleeping through the night, he must be placed into the crib drowsy but awake. The problem is that most people misunderstand this concept. Then, when they try to implement it, they don't even realize they're doing it wrong.

When sleep training your child, you are teaching him how to put himself to sleep at the onset of sleep so that he can do it again in the middle of the night. If your child isn’t putting himself to sleep at bedtime, it is unfair to expect him to put himself back to sleep at 2:00 a.m.
 
For your child to learn the skill of putting himself to sleep, you must give him the opportunity. Entering the crib fully asleep after being rocked to sleep defeats this purpose. This means your baby must be placed into the crib “drowsy but awake” so he can learn how to put himself to sleep.
 
How do I do it, and make sure I do it right?

1. You want to do the bedtime routine at the right time--not too late. Waiting till the last minute to start the process is already too late.

2. Once you are done with feeding and the bedtime routine, lay your child down in the crib awake, not asleep. Make sure not to rock or hold him too long, or feed him to a drowsy state.

3. If your child is awake when you are done with the routine, you don’t need to hold him until he gets to a drowsy state. In fact, the more awake, the better.

4. On a scale from 1-10 (1 being awake and 10 being asleep), your child should not be past a “6." So if your child is drowsy, make sure he’s not too drowsy where his eyes are closing and he’s struggling to stay awake.

5. Finally, if you child is falling asleep “within a minute,” he is entering the crib too drowsy. Often parents say, “oh, he was awake and as soon as I put him down he just turned over and fell right asleep.” If that's happening, he’s too sleepy when you put him in. On average, it takes up to 15 minutes for a child to put himself to sleep. So if he really fell asleep within a couple of minutes, then he was more asleep than drowsy but awake.

You can start practicing DBA with your baby as young as 2 months. At this point you will still need to assist your little one in putting himself to sleep, as he is still too young to learn how to self-soothe. But you can definitely start practicing!