Sleep Training for Babies: How Everyone Can Get a Better Night’s Sleep
Apr 20, 2021
The joys of having a new baby…. and oh, the restless, sleep-deprived nights! One of the most common questions I get asked as a pediatrician is how to sleep train a baby. I’ve counseled hundreds of families on sleep training over my decade of experience as a pediatrician. This is my time-tested recipe for establishing a sleep routine early on.
Step 1: Set Up Realistic Expectations
Sleep training means teaching your baby to fall asleep when you put them into a bed fully awake. This is important, so that they learn to fall asleep without being rocked and cuddled and nursed. If a baby only learns to fall asleep while being rocked, guess what happens when they wake up? They cry until you rock them back to sleep, a recipe for sleepless nights as a parent.
Even as adults, we still wake up in the middle of the night. Waking up through the night is normal. What we want to teach babies is to be able to go back to sleep on their own, after they wake up. Rest assured that different babies have different temperaments. Some babies are more difficult to sleep train, and this is normal.
Step 2: Utilize the EWS Cycle
As a newborn, start your child on a consistent routine. Typically, a cycle of eat-wake-sleep (EWS) in 2-to-3-hour increments is most appropriate during the day, and will gradually lengthen to 4 hour cycles with several longer naps, as they get older. When you wake your baby to feed them, try to keep them awake during the feeding and until it’s time to go to sleep again. This awake time can range from 30 minutes to 2 hours (depending on their age) and will get easier over time. Try to talk to and play with your baby while they are awake, so they sleep better during naptimes.
The order of the cycle is important. Notice that it’s not eat-sleep-wake. Feeding a baby to sleep makes sleep training more difficult, so one of the goals is to teach a baby to fall asleep on their own without a bottle in their mouth. Always get advice from your pediatrician, because some babies need more specialized care and schedules (for example, preemies and kids with special needs).
Step 3: Find a Schedule That Works
There are many sample schedules for parents to try, but it’s really the daily consistency in the schedule you choose that is key. Just like adults, babies like predictability. Find a schedule and stick to it. This will keep your baby less fussy. Daytime naps are very important in children, and the schedule should change over time to have fewer daytime naps and longer periods of sleeping overnight as the child gets older. Some babies have their days and nights mixed up when they are born. Keeping a consistent routine will help these babies get back on track.
Step 4: Start Sleep Training
Practicing a consistent naptime and feeding routine should start as a newborn, but sleep training is generally recommended around 4 months of age. When we talk about sleep training at night, it doesn’t mean that there is no feeding. Young infants still need feedings through the night, even while sleep training.
Research has shown that sleep training doesn’t cause emotional or attachment issues later in life. It’s important for babies to have a consistent sleep routine so that they are well-rested, active and ready to learn during the day. Babies rub their eyes, yawn, and get fussy when they are sleepy. Put your baby to bed when you notice these cues, before they get too tired, but also before they fall asleep completely. If you wait too long, they can become overtired, making it harder to get them to sleep. Following a consistent bedtime routine helps babies transition from awake to sleepy time.
Step 5: Respond to Nighttime Wakings
Always make sure your baby is healthy and well-fed before starting sleep training. A new move, a new caretaker, or a new illness are all times to postpone sleep training. Crying can be a sign of illness but is also a normal part of baby development, so your pediatrician can help you determine what is normal and what is not.
Most experts recommend, assuming your baby is healthy, letting them cry at night for a set amount of time, quietly checking on them and consoling them briefly. Over several days, try to reduce your time in the room, decrease the degree of consoling and let them settle themselves down. Gradually, their episodes of crying at night should become less frequent. Try to resist the temptation of picking them up every time they cry or rushing into the room at every whimper, because self-soothing is an important skill that babies learn during sleep training.
If sleep training doesn’t work after a couple weeks, it may be time to call your pediatrician.
Emily Decker, MD, is an assistant professor of pediatrics in the Urgent Care and Primary Care Clinics at Nationwide Children’s Hospital. She has a strong interest in child advocacy, and serves as the medical director for CAP4Kids Columbus.
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