There are books and books that are written about sleep training. The main thing to keep in mind is to work with your physician, your pediatrician, to ensure that your baby is developmentally ready to be able to sleep longer periods at night and they are growing appropriately in order to be able to go between feedings longer periods at night.
Around four to six weeks of age is an appropriate time to start thinking about it. Between six to eight weeks of age, they’re neurologically ready to go longer periods of time. That's around the time we can start laying the foundation.
It’s usually when they’re starting to be able to go longer periods at night, anywhere between 10 to 11 pm is one bedtime. As they go even longer, between three to four months of age, they can go nine to 10 hours at night. Typically, the bedtime is between 7 to 8 pm.
That depends on which developmental stage they’re in. Between six to eight weeks of age, sleeping through the night means about five hours, which is a treasure for parents who are used to getting up every two to three hours. After that, they’re able to go longer periods, about 10 hours.
They’re still growing very rapidly. They’re doubling their birth weight in the first six months. Limiting their feedings to only daytime hours is not enough for them. They still need some of those nighttime feedings. As they wake up, they also have wet diapers and bowel movements that need to be changed in association with the feedings.
Not necessarily. Babies are able to sleep long stretches if we don’t interrupt them too much and if we allow them the opportunity to learn how to sleep.
Initially, they need quite a bit of sleep. Usually within the first three months or so, it can be even up to 17 hours of sleep in a 24-hour period, usually 14 to 17 hours. After about four months of age, they can go anywhere between 12 to 14 hours of sleep in a 24-hour cycle.
Initially, that makes parents feel a lot more comfortable to have their newborn near them. But keep in mind that around two to three months of age, they’re a lot more aware of their surroundings. Any movement or noise that’s made in the room could affect their sleep, and that includes daytime sleep if they’re sleeping in a living room. They’re a lot more attuned to their environment. It’s up to the parents to decide when the appropriate time is to move the baby.
If they hear your voice, it could potentially interrupt their sleep. It depends on what they’re getting up for. Usually, they’re in deep sleep. If we don’t interrupt them during the time that they’re in those different sleep cycles and changing between sleep cycles, they’re able to get to the other side without us interfering. Unfortunately, we do tend to interfere more. Sometimes our voice could be too much stimulation for them when they really just need to sleep.
Initially, that’s a good way to start the foundation of sleep training. We’re holding our baby. We’re feeding our baby. But at some point, you want them going to sleep on their own. I usually recommend holding and feeding and then detaching once they’re starting to get a little bit sleepy and then laying the baby down. That, you can start even at four, six, eight weeks of age.
The American Academy of Pediatrics does not recommend co-sleeping. Usually, if there’s any co-sleeping, there is a risk with pillows and blankets, alcohol use, extremely sleepy parents, which is basically every parent of a newborn. The risk is greater than the benefit of co-sleeping.
Initially, the babies are probably falling asleep as they’re feeding. The goal would be to try to detach them either from the bottle or the breast before they fall fully asleep, or as they’re getting sleepy.
As they get older, you want to be feeding them well before it’s sleep time and ideally in a different space than where they’re normally going to fall asleep. If you have a six-month-old baby, feed them in the living room and get them to sleep in their room.
That’s been debated for centuries. It really depends on which sleep training technique that you feel you and your partner can proceed with. Most sleep training techniques do require some sort of crying to allow your baby to learn how to sleep.
There’s the cry it out or Ferber method. That’s when you go into the room when the baby is crying and you start off with say 10 minutes of them seeing that you’re there, but trying not to pick up the baby. Then the next time, it’s a shorter period of time that you’re in there when the baby is crying.
Most of the sleep training methods really focus on not picking up the baby when the baby is crying. There are different sleep training methods that will work for the baby, but not the parents and vice versa. You have to pick the one that you’re going to be able to sustain long-term because sleep training is not one-time and that’s it. It’s really something that you have to revisit.
Sleep training is a learned behavior. But babies also get sick. There’s a time change. You travel. You always have to come back to a method. You always have to be able to come back to it to get them back on a routine.
A good place to start initially is when they’re ready to be able to go longer periods at night between feedings, usually about six to eight weeks of age.
Usually at two to three months is a good time to work with your pediatrician to make sure that your baby is ready to be sleep-trained. That’s when the discussion about how long to cry is going to work for your family.
Usually, we try to work with parents to find out what is the sleep training technique that they are going to be able to maintain and be consistent with. Sometimes, parents are only able to handle five minutes of baby crying. Sometimes, they can last an hour of a baby crying. You have to work with the family to see what they’re able to do as a partnership.
You need to be consistent and to revisit that sleep training technique later on. You have to agree that this is one of the most important things that you’re going to be teaching your child. Allowing them to learn how to self soothe and to get an appropriate nighttime sleep is really important for their future in so many ways.
Ideally, it depends on how far along you are in the sleep training method. Initially, there’s a lot more crying, and then that duration of crying should be less and less. But there is some crying that is involved as you’re getting them to sleep initially and then also every subsequent time that they wake up. What you want to make sure is that there’s not some other reason why your baby is crying. Do they have a fever? Are they teething? Are they getting sick? You want to ensure that the reason that they’re crying overnight is not related to that but that they’re still learning how to sleep at night.
For a lot of babies, that can be very soothing. Like with anything that can become a habit, you want to make sure you have an exit strategy, when you’re going to wean it. For instance, the American Academy of Pediatrics has found a decreased risk of SIDS when using the pacifier. SIDS is Sudden Infant Death Syndrome, which happens in babies less than six month of age. Keep in mind, a pacifier could be a long-term habit that’s hard to eliminate as easily.
Keep in mind also that it’s not a one-size fits all strategy. What worked for your first child may not work for your second child. The most important thing is to understand that the personalities of children are different. Consistency when it comes to using a sleep training technique is the most important factor to success.
When the baby is ready to be sleep-trained, that trust is ideally being built at other times of the day. Cuddling and snuggling and rocking and interacting with your baby should be occurring during the daytime as well. The very important thing that you’re teaching your baby by allowing them to self-soothe is that nighttime is for sleep and daytime is for all of the other activities that continue to build trust and solidify that bond between parent and child.
You want to make sure that first and foremost, your baby is ready developmentally to start the sleep training process, that they have shown appropriate weight gain and are growing well, feeding well.
If there are any signs of fever, vomiting, not feeding as well during the daytime or even teething, then you want to make sure you involve your pediatrician in the conversation as you proceed with sleep training.
It’s really important initially when your baby is on that 24-hour cycle that you do get a little bit of sleep in the daytime because that is going to impact your mood, supply of milk. It impacts so many things.
If the baby is on the 24-hour cycle, that means that you’re on the 24-hour cycle too. Be respectful of yourself and allow yourself that space and know that it’s not forever even though it feels like that on many days. It will come to an end soon.
The most important thing is to work with your pediatrician to ensure that your baby is ready developmentally to sleep-train and start to allow your baby to self-soothe by detaching the feeding and allow them just to be laying down when they’re just a little bit sleepy. Eventually, in three to four months, think about what sort of sleep training techniques are going to work for your family and for your baby, partner with whoever you have around you for support.
Be as consistent as you can going forward, knowing there will be days you want to throw in the towel and you can’t do this anymore, but tomorrow is another day and you just keep moving forward with it.
Watch the San Diego Health video with host Susan Taylor and guest Dr. Gurinder Dabhia, discussing how to help your baby sleep through the night.