Infant Sleep Research: Bedsharing, Self-Soothing, and Sleep Training

This is the fifth post in my sleep series. In my last post, I discussed how my view of infant sleep has evolved to be more inclusive of a wide range of solutions that can work in different families. In this post, I look at what the research tells us about infant sleep across the spectrum of nighttime parenting philosophies.

[Please note: It is beyond the scope of this article to discuss the bedsharing/crib/SIDS/suffocation debate, but suffice it to say that parents should pay careful attention to making baby’s sleep environment safe, whether the baby bedshares or sleeps in a crib.]

Bedsharing Infant Sleep

Let’s say that you choose to bedshare. You feel that the best place for your baby is right by your side, in your own bed. (I use the term “bedsharing,” because the more commonly used “cosleeping” can also mean sharing a room but sleeping on separate surfaces.) Many parents choose to bedshare because it just feels right, even if they had carefully prepared a crib before the baby’s arrival. BabyC slept in my bed for a couple of weeks early in her life, though it was not my plan and ultimately ended up not being the choice that Husband and I made. Still, in those weeks, I felt a real shift in my bond with BabyC. It certainly made breastfeeding during the night easier, and it was sweet to wake up and watch her sleeping next to me. I understand the choice to bedshare, and I think that for many families, it can have numerous benefits. These benefits are not well-defined by research, however. For example, I have yet to find study that investigates if bedsharing actually increases infant attachment.

Bedsharing is common around the world. In an international survey of parents of over 29,000 infants and toddlers, bedsharing was the norm in Asian cultures, while most Caucasian parents put their babies to sleep in a separate room [1]. Across cultures, babies that bedshared went to bed about 1 hour later, woke their parents more during the night, and slept about 1 hour less per night.

Several controlled studies give us a more detailed and slightly different look at the sleep patterns in bedsharing infants, though they are all limited by very small sample sizes. One study used video recording to observe 18 age-matched infants (3-15 months) sleeping in their own homes and found that bedsharing babies slept just as much as solo-sleepers [2]. The bedsharing babies did wake more often during the night but transitioned back to sleep faster than the solo-sleepers, so both groups of babies spent about the same amount of time awake and asleep during the night. This study did not report how often the baby actually woke the parents, and it is likely that the solo-sleeping infants transitioned back to sleep on their own without calling for help for at least some of their wakings.

Dr. James McKenna and colleagues looked closely at the sleep of 35 mama-baby pairs (11 to 15 weeks old) in a laboratory setting. They found that both mothers and babies woke more often when they bedshared, and these arousals usually overlapped [3]. These data led them to hypothesize that bedsharing could be protective of SIDS, since it encourages more frequent arousals than solo sleep. This is an intriguing and plausible hypothesis, but it has not been further investigated. Another laboratory study of breastfed babies found that those that bedshared nursed more often and for longer time during the night than babies that slept alone [4, 5].

Many of the differences in sleep patterns between bedsharing and solo sleeping infants likely occur because bedsharing infants may not learn to self-soothe at night until later in childhood. After all, Mom or Dad are almost always there to help them transition to sleep at bedtime and during normal night wakings. It is not clear if the differences in sleep patterns have any significant effect on the health or well-being of infants one way or the other. There is SO much room for more research on cosleeping and bedsharing. For example, why do some bedsharing babies wake once per night and others wake every hour? Does the more frequent waking make them less rested than babies with more consolidated sleep, or do bedsharing babies get the sleep they need? Does more frequent night nursing improve their nutrition or breastfeeding success?

Regardless, when parents make an intentional choice to bedshare, they are likely to accept frequent night wakings as a natural part of parenting. Bedsharing and the associated night wakings are more likely to be seen as a problem in a family that really doesn’t want to bedshare but takes the baby into bed during the night out of desperation.

Solo Infant Sleep

Now let’s say that you prefer for your baby to sleep in her own bed. You also probably want her to have a nice consolidated night of sleep without needing much of your comfort, because providing comfort in the middle of the night is much more disruptive if you are sleeping in a different bed or a different room from your baby. Of course, if she really needs to be fed, you’re happy to do that, and if she isn’t feeling well, you’ll be there for her. However, you don’t want to have to rock her back to sleep every time she has a normal night waking. You hope that she can transition back to sleep on her own without asking for your help. As I explained in my previous post, she needs to learn to self-soothe.

In an ideal world, babies learn to self-soothe by being given gradual opportunities to try it out. Several randomized controlled trials have shown that when parents were counseled about strategies to encourage self-soothing in their babies – like putting the baby down drowsy but awake and not jumping up to intervene at every little peep in the night – their babies learned to self-soothe and sleep longer at night from a young age [6, 7]. A soothing bedtime routine can also help form healthy sleep habits early on [8].

What do you do if your baby doesn’t learn to self-soothe using these early strategies (or if, like me, you disregard them)? At some point, most babies who sleep alone but don’t know how to self-soothe will start to have more difficulties with falling asleep at bedtime and frequent night waking, as we found with BabyC. In some families, night wakings are not a huge problem, and parents simply cope with them. In others, they cause chronic sleep deprivation that becomes a health concern for the family, and this is the point when most families consider sleep training.

All of the various sleep-training methods were developed to help babies learn to self-soothe, and the research shows that these methods are effective. In a 2006 review, Jodi Mindell and colleagues reviewed 52 studies, published between 1970 and 2005, of the major sleep training methods [9]. Eleven of these were randomized controlled trials, including a total of 1,135 children between the ages of 6 weeks and 5 years. A few more controlled studies have been published since then, and I’ve included these in my summary.

In study after study, sleep training has been found to have the following outcomes, usually within 1-2 weeks:

  • Reduced bedtime struggles, fewer night wakings, and longer sleep for baby, and consequently, for parents [9, 10].
  • Improved maternal mental health, with fewer moms being clinically depressed [11, 12]. In some studies, parents have also reported less parenting stress and greater confidence, as well as more marital satisfaction [7, 9, 10].
  • Improved baby temperament and mood, as reported by parents [13-16], usually the mother. Of course, a mother is not exactly the most objective judge of her baby’s behavior, but I would argue that she is the most important one. Still, it is difficult to know why babies were rated as less irritable and more secure following sleep training. It could certainly be that they were getting more and better sleep, directly reducing crankiness. It could be that mom was better-rested and thus more tolerant of fussiness and focused on positive interactions with her baby. Or, it is possible that baby’s self-soothing skill resulted in better self-regulation during the daytime, too. Whatever the cause, this is a good thing for the mom-baby relationship. Furthermore, of all the studies of sleep training, not a single one has identified a negative effect on babies’ behavior or relationship with caregivers.

Several studies have followed up on children one year after sleep training. By two years of age, the sleep-trained children were still sleeping well, but the control kids were, too [16, 17]. The parents of the control children may have done some type of sleep training in the intervening time, or their kids might have just started sleeping better on their own. And a few kids, whether sleep-trained or not, were still struggling with sleep.

The major sleep training methods that have been tested in controlled trials are Unmodified Extinction (child put to bed awake and no comfort offered if he cries); Graduated Extinction (parents check periodically and briefly comfort the child, also known as the Ferber Method or controlled crying); and Extinction with Parental Presence (parent “camps out” with baby while he cries, gradually withdrawing presence).

So, among these methods, which is the best? They all work. There is no evidence to suggest that any one of these interventions is more effective than the next. This is not surprising, since all of these methods teach children to self-soothe. This is good news for parents, because it means that they can choose from a range of methods to find the one that is the best fit for their family.

Among all the many guides to infant sleep on the market today, there are endless variations on sleep training that have not been directly tested. Many of them offer methods that are more gradual and emphasize more parental presence (for example, the Sleep Lady Shuffle, The Baby Whisperer’s pick up/put down method, and variations in the No-Cry Sleep Solution). This idea is appealing to parents, because we all hate to hear our babies struggle and cry. While these methods have not been directly tested in controlled trials, the reported success of “Extinction with Parental Presence” indicates that these probably work as well. Again, as long as the baby learns to self-soothe, he’s going to be better prepared to sleep well on his own. However, the process may be slower, and in some babies, it may be more frustrating to have the parent present but not offering soothing. Still, I think it makes sense to consider trying one of these methods, with the idea that parental presence may make the transition less stressful to the baby.

Although there are plenty of studies on sleep training, there are some major gaps in the research. Most importantly, we know very little about how babies respond to sleep training at different ages and developmental stages. Sleep training has been tested on young infants, but many studies also included toddlers and preschoolers, and the results were averaged together for all children. More recent studies have specifically targeted 6- to 12-month-old infants [10-12]. Several parental education studies targeted very young infants with self-soothing strategies but were not explicit about how they advised parents to handle crying [6, 7, 18]. Babies make huge developmental leaps in the first few years of life, and these developmental changes certainly influence how the baby feels and thinks about sleep training and, ultimately, the success of sleep training [19]. For example, a baby might sail through sleep training with little stress at 6 or 12 months, but try it at 9 months, when most babies experience separation anxiety, and after a lot of crying, you might decide that your baby is one of those that simply won’t sleep on his own! And some babies, regardless of age, just might not cope well with separation or sleep training. More research is needed to help identify these babies so that parents can be encouraged to try alternate strategies.

Finally, the research has failed to directly address parents’ greatest concerns with sleep training: How stressful is sleep training for my baby? Will it make my baby less attached to me? These are really important questions, and I will do my best to address them in my next post.

Ultimately, the best sleep solution to get you through these early years of parenting is the one that is most sensitive to the needs of your child and your family. If you think that bedsharing will make you a more sensitive parent, but you hate bedsharing and feel resentful of broken nights of sleep, then it probably isn’t the right answer for you. If you think that your baby should sleep in her own bed but feel guilty about it and wish you could snuggle with her every night, well then, it may be time to reevaluate that choice as well.

I always love your comments about what worked and what didn’t to help everyone in your family get enough sleep. I’m especially interested in hearing from people who tried a more gradual method of helping their babies learn to sleep on their own. Anyone have experiences or advice they’d like to share?

Check out other posts from my infant sleep series:

REFERENCES

1.  Mindell, J.A., A. Sadeh, B. Wiegand, T.H. How, and D.Y. Goh. Cross-cultural differences in infant and toddler sleep. Sleep Med. 11(3): p. 274-80. 2010.

2.  Mao, A., M.M. Burnham, B.L. Goodlin-Jones, E.E. Gaylor, and T.F. Anders. A comparison of the sleep-wake patterns of cosleeping and solitary-sleeping infants. Child Psychiatry Hum Dev. 35(2): p. 95-105. 2004.

3.  Mosko, S., C. Richard, and J. McKenna. Maternal sleep and arousals during bedsharing with infants. Sleep. 20(2): p. 142-50. 1997.

4.  Gettler, L.T. and J.J. McKenna. Evolutionary perspectives on mother-infant sleep proximity and breastfeeding in a laboratory setting. Am J Phys Anthropol. 144(3): p. 454-62. 2011.

5.  McKenna, J.J., S.S. Mosko, and C.A. Richard. Bedsharing promotes breastfeeding. Pediatrics. 100(2 Pt 1): p. 214-9. 1997.

6.  Kerr, S.M., S.A. Jowett, and L.N. Smith. Preventing sleep problems in infants: a randomized controlled trial. J Adv Nurs. 24(5): p. 938-42. 1996.

7.  Wolfson, A., P. Lacks, and A. Futterman. Effects of parent training on infant sleeping patterns, parents’ stress, and perceived parental competence. J Consult Clin Psychol. 60(1): p. 41-8. 1992.

8.  Mindell, J.A., L.S. Telofski, B. Wiegand, and E.S. Kurtz. A nightly bedtime routine: impact on sleep in young children and maternal mood. Sleep. 32(5): p. 599-606. 2009.

9.  Mindell, J.A., B. Kuhn, D.S. Lewin, L.J. Meltzer, and A. Sadeh. Behavioral treatment of bedtime problems and night wakings in infants and young children. Sleep. 29(10): p. 1263-76. 2006.

10.  Mindell, J.A., C.E. Du Mond, A. Sadeh, L.S. Telofski, N. Kulkarni, and E. Gunn. Efficacy of an internet-based intervention for infant and toddler sleep disturbances. Sleep. 34(4): p. 451-8. 2011.

11.  Hiscock, H., J. Bayer, L. Gold, A. Hampton, O.C. Ukoumunne, and M. Wake. Improving infant sleep and maternal mental health: a cluster randomised trial. Arch Dis Child. 92(11): p. 952-8. 2007.

12.  Hiscock, H. and M. Wake. Randomised controlled trial of behavioural infant sleep intervention to improve infant sleep and maternal mood. BMJ. 324(7345): p. 1062-5. 2002.

13.  Eckerberg, B. Treatment of sleep problems in families with young children: effects of treatment on family well-being. Acta Paediatr. 93(1): p. 126-34. 2004.

14.  France, K.G. Behavior characteristics and security in sleep-disturbed infants treated with extinction. J Pediatr Psychol. 17(4): p. 467-75. 1992.

15.  Minde, K., A. Faucon, and S. Falkner. Sleep problems in toddlers: effects of treatment on their daytime behavior. J Am Acad Child Adolesc Psychiatry. 33(8): p. 1114-21. 1994.

16.  Hiscock, H., J.K. Bayer, A. Hampton, O.C. Ukoumunne, and M. Wake. Long-term mother and child mental health effects of a population-based infant sleep intervention: cluster-randomized, controlled trial. Pediatrics. 122(3): p. e621-7. 2008.

17.  Mindell, J.A., C.E. Du Mond, A. Sadeh, L.S. Telofski, N. Kulkarni, and E. Gunn. Long-term efficacy of an internet-based intervention for infant and toddler sleep disturbances: one year follow-up. J Clin Sleep Med. 7(5): p. 507-11. 2011.

18.  Pinilla, T. and L.L. Birch. Help me make it through the night: behavioral entrainment of breast-fed infants’ sleep patterns. Pediatrics. 91(2): p. 436-44. 1993.

19. Lewis, M. D. and I. Granic (2010). Bedtiming. New York, NY, The Experiment.

54 thoughts on “Infant Sleep Research: Bedsharing, Self-Soothing, and Sleep Training

  1. Great article…I like Mindell’s work and Dr. Harvey Karp as well. Have worked with the Sleep Lady, Sleepy Planet and some other similar approaches to sleep training. As you stated I too am not opposed to co-sleeping as long as the safety guidelines are used so that baby is not at risk.
    Sleep solutions should be on the to do list of parents to be so that they can make an educated choice when faced with sleep hunger and a sleepy baby.

  2. Great article. I was too scared to cosleep with my son because he was so little and a preemie. But I couldn’t even think about sleeping in a separate room as him. So even though he has a crib he still shares my bedroom with me. I keep him in a pack and play. It’s nice because it’s right next to my bed. So when he wakes up at 5AM for breakfast I can be there to give him his food right away. But I try not to jump up every time he cries, I really try to see if he can figure out whatever is distrubing him. But I can also tell based off of his cries if he really needs me or not.

  3. We are using a more gradual method in our family. We started out wanting to co-sleep with our son in a co-sleeper bed. Yet we quickly noticed he preferred to sleep all by himself in his crib in his room. His body would noticeably relax when we entered his room.
    Without putting in any effort our son started sttn at 2 months. I would dream-feed (nurse) him at 10pm and he would sleep through until 8-9am. Sadly he stopped continuously sttn at 5 months (which is when he started sitting up unassisted, and cut his first tooth) and he has not slept through the night at all since he was 6 months old.

    We did however switch him from a crib to a Montessori floor bed at around 11 months. This is when he started hating the crib. He is now 18 months and has slept on a queen-size mattress on the floor ever since. We still are not actively sleep training, but we do use several methods from the No Cry Sleep Solution. (They are just common sense things.) I feel like nothing really helped our son sttn and we are not willing to take it further.

    He has been a lot happier in the new sleeping arrangement. He lets me know when he wants to sleep (through baby sign language) and runs and jumps into bed. But he still nurses to sleep. Waking up (in the morning or after a nap!) means a lot of happy babbling, playing and reading books. The Montessori bed has not affected his sleep, but his attitude towards it. (And a tired mom or dad gets to pass out on those nights with one too many wake-ups right next to their child.)

    We have seen a big shift the last week and a half. It is too short a time to be certain it is a behavioral change, but our son has started sleeping long stretches again. 7 to 10 hours even. This coincides with him acting more independent and confident in social interactions. But it also happened right when he started eating more solids, instead of still mainly relying on breastmilk. So for us, sleep does not seem to be something you can force, it just happens. For whatever reason that may be.

    • Well…actually, sleep is something you’ve chosen not to force, based on your post. You say you don’t “actively sleep train”, which means that you have decided it’s not for you, and that’s great if it works for you. But you likely could sleep train if it was what you decided you needed.

      Our daughter also stopped STTN at six months, and, at nine months, I decided I just couldn’t take it anymore – she woke every two hours for three months, and I was a zombie. So I used (on another scientist-mom-friend’s suggestion) the Sleep Lady method on her. She was going to sleep on her own in a week, and has ever since (and, once she learned to go to sleep by herself, also STTN).

      Our son (six months right now) still often gets rocked to sleep after nursing. He STTN, so I’m not panicking over sleep training him. Maybe we’ll get lucky with this one – he does go to sleep on his own if I put him down awake.

    • I also use a Montessori floor bed with my 3 month old and so far I love it. I’ve also chosen not to formally sleep train (yet), and though he doesn’t sleep through the night yet, he can go to sleep with only the aid of a pacifier and can usually self-soothe himself through night wakings except for when (I think) he’s hungry—at 4-5 hour intervals.

      What I love about the floor bed is it allows me to “co-sleep” when I want to (I love sharing afternoon naps with him) or feel he needs it (when he’s not feeling well), but he’s learning to associate sleep in his OWN bed, and I can always return to my own bed (and my husband) whenever I wish.

      I AM looking forward to/concerned about him sleeping through the night, and I wish I had a better way to gauge if he is really hungry or if he just needs more help self-soothing through his wakings. He does take a full feeding, and usually a BM around 4am, but the literature says he *should* be able to sleep through the night by now. I’d be interested to know if there was more research on “sleeping through the night” as well as the going to sleep research.

  4. We didn’t start co-sleeping from the start but found that it was how we all were going to sleep better at least for a while, I had a very hard time getting up soon enough when my son was an infant which would cause him to fully wake up and wake up more times, once he started sleeping with us it was just a couple of feedings that didn’t disturb me as much. Then when he was about a year old, we started placing him on his pack and play (this is only because our unique situation, due to my husbands work we had to move temporarily and put everything in storage and we had no crib where we were living), after his first awakening he would come to our bed. Then around 18 months old (and after we were settled in our home) I would nurse him and then he would go to sleep on a mattress on the floor next to our bed, that and his age helped him sleep finally longer stretches until he slept through the night, at some point when he tried to go back to our bed we decided to bring him to his room to sleep on his toddler bed, he had been napping in there already and my husband laid next to him for 2 nights, he has slept great since then and now he is 3 1/2, I know this is a rather long process but there is such thing as babies learning to self sooth sooner or later :)

  5. We used Pantley’s No Cry method twice with success, at 12 months and 24 months. I found that I had a hard time sleeping in another room, even with a monitor, so cosleeping was primarily my choice.

    Both times took about two weeks. There was a lot of crying, as she wanted to be held, but we touched and soothed her as much as she needed.

    At 15 months, she needed tubes, so I moved back with in her after the surgery and found it easier to stay with her. She was sick a lot and we werent ready to try again for awhile. By 24 months, I couldn’t put her down in her crib, so we transitioned to the futon in her room. We found that she would only sleep until 3, though. When she started coming out of her room, but was unable to make it to our room, and therefore out of range of hearing until she was wailing, I moved back in. She would sleep all the way through if I was next to her, so we both got more sleep that way.

    She needed tubes again at 37 months, and our house is still torn up from some water damage, but once everything is back to normal, we plan to try the No Cry method again, as she is able to sleep all night on her own now, but we didn’t want to throw too many changes at her at once. And it’s not safe for her to try to make her way through the construction at night. :)

    We didn’t plan on cosleeping, but then there have been a LOT of things we haven’t planned on. One thing that has really helped me is exercise. I find that regardless of our sleeping arrangements, we do better when there’s a lot of physical activity during the day. Unfortunately, my fitness plan keeps getting interrupted with health problems, so I have lots of experience with both…

  6. Interesting concept. I’m not a parent-by-manual type of mom but have recently started reading certain articles out of curiosity. I am currently bedsharing with my 12th child who is now 9 mons and still nursing. I believe that the personality of the child must be understood, learning how she would like her needs met is our first job as a parent. With careful observations this can happen in a short period of time. Remember that the new infant is learning about its environment every minute, they are adapting to you as much as you are to them. I believe the personality of the child is nature AND nurture. We determine how the infant displays needs and how that evolves through each developmental stage. One important point to consider is cultural norms. In my culture, infants and small children are not to be left alone in rooms by themselves especially at night because they are still attuned to the spirit world they come from.

    • 12th child! :) You must have a lot of practice… I would love to see a break down of how you dealt with each personality. What culture are you a part of? I love how you said ‘they are still attuned to the spirit world they come from.’

  7. I suppose our approach would be called controlled crying. We got it out of one of Penelope Leach’s books. At the time, I was amazed that I had never heard of it before — it seemed like such an obvious middle ground between absolute cry-it-out and absolute attachment / co-sleeping.

    For the first three months or so, we found our little one went to sleep best by being carried and walked around. Around the end of three months, she started waking a half hour after we’d put her down. That’s when we decided to try the controlled crying. We would do a bedtime routine — bottle, story, that sort of thing, and then put her to bed sleepy but not asleep. If she cried, we would wait a moment to see if she stopped — if not, one of us would go in and pat her without picking her up, and say something like “It’s bedtime; we’re here.” We would repeat this as needed. For us, the first two nights had some repetition, and then for a few more days we might need to go in only once, and then it was pretty much done.

    We felt that this method was respectful of both baby and parents — we held to a boundary, but offered what comfort we could.

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  10. Great blog, great post – I can’t believe I’m only just now finding you! Our son now, almost 3, slept in our our bed until about 6 months ago. Traveling helped some- we were sort of forced to sleep separately because family guest rooms weren’t equipped with safety things. We tried various ways to gradually move him out, get him to sleep on his own, etc- all to fighting, screams etc and it just wasn’t worth it. And I agree with others that the personality of the child and spiritual considerations must be made- he wasn’t emotionally ready to be alone at bedtime. Bedtime nursing was still important, so eventually the thing that worked was a big bed. He hated the toddler bed and would flop around so much in his sleep he was always hitting his head on the side and waking himself up. So we got a full size bed, put up a safety rail, can now crawl in with him to read stories, and then leave when he is nearing sleep or is comfortable. We are all happy with this- and I feel very happy with how it went for us, bedsharing with the gradual move. But he got BIG! And took up a lot of space! :-) It is nice to read others experiences in a calm, respectful manner.

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  12. When my daugther was in her first few months, we always put her down awake, and she would gently fall asleep on her own. From the day she came home from the hospital she was sleeping in at least 4 hour chunks through the night. Some nights longer for her first stretch of sleep. But it never got better. We are now beyond 6 months, and she still wakes once or twice a night, and thats even with a wake up time of 6:30am when the house is up getting ready for work. She also used to have no problem being put in her crib to fall asleep slowly on her own, and as she has gotten older I’ve noticed that is not so much the case anymore.

    We decided it was time to do something. There had been random nights that she slept for 8 or 9 hours, but only maybe once a month. Still, we knew she could get through the night without nursing, which was a large decision maker for us that it was time to do something.

    The first night we did a basic, let her cry method. In thinking about it, I’m sort of skeptical of the “going back in every 5 minutes.” It sort of seemed to me that all it would teach her, is if she cries long enough, we will come back in to comfort her. The first night she cried for 15 minutes, and then went to sleep. She still woke up in the middle of the night, and it was at this point that it was much harder for her to go back to sleep. We stuck it out, and this time did comfort at intervals, but my husband did it so she wouldn’t sense the milk.

    The second night (last night), we realized moments after putting her in her crib, that we had not put the mesh bumpers on, as we had planned. We decided to just go in, and very calmly put them on the crib without removing her. She stopped crying shortly after we entered, and watched us. Once we were finished, we kissed her goodnight, walked out and shut the door. She was asleep in only 5 minutes, and slept for 8 hours straight. When she woke up (at 4am), we opted to feed her (mostly because I was in pain I was so full!) and she went back to sleep in her crib with no problem.

    Tonight we hope to get her back to bed at her normal time of 7:30 since we were late last night. I’m hoping the “going to sleep earlier, sleeping longer” rule of babies will apply and we might have another good long night of sleep.

    In the end, while I understand the gradual method, there was part of me that considered total crying time overall. Between putting her down the first night, her middle of the night waking, and last night’s crying, there was only a total of about 1hr. 5 min. Had we stretched this out into a more “gradual” method, that took a week or more, I feel like there would have been more crying overall. Sure, the first night when she cried for 45 minutes at 2am was awful. But if the “tough love” night makes the whole process go faster, it feels worth it to me. She was sure smiling this morning.

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  17. Pingback: The Last Word on Sleep Training? | Science of Mom

  18. I have a 12 month old who wakes on avg 3-4 times a night. It’s our 2nd baby and we know all about sleep training, however the sheer logistics of our situation have frustrated this. We have a 2bdrm apt and baby sleeps in crib in our room. noise carries and at first the crying used to wake our 4year old, so I would attend to the baby to minimize this. we tried sleep training at 4 mo, 5 mo, 6mo, 7mo, 8 mo, 9mo, 10mo, 11mo!!! (We sleep in another room and use extinction method). it starts working, but Have never been able to be consistant, because husband is away 4 days in week and when I eventually return to sleeping in my bed, I pick up the habit of attending to baby, feeding, because I am too tired to listen to her crying. Note that I am an exhausted waste case. we are trying again tonight and she has just cried and rocked herself awake-to sleep for the past 1.5 hrs!! Very difficult.

  19. I have a 9 month old baby girl who still wakes very frequently each night (every 40 minutes to 3 hours, unpredictably) and only takes 1-2 30 minute naps during the day. We co-sleep, and she goes between our bed and a crib next to our bed. I love having her sleep nearby but she can be so restless that i usually sleep better when shes in her crib. But by 2/3am she is totally restless and only happy and resting with a boob in her mouth and i do my best to try and sleep through it. But i am officially at the end of my rope. Aside from any science per say i have always leaned towards not crying it out. On a deeply intuitive level it just doesnt feel right to me, at least not with my daughter. And from 6 months till now her teething has gotten worse and worse (still no teeth yet) and i cant come to terms with depriving her of comfort during this time…. However, i am coming to a place where i sense that the deterioration i feel from this horrible sleep deprivation is possibly more traumatic and damaging then having her cry it out. I am totally torn. I dont know what to do! I speak to moms who did the sleep lady approach, which seems more my speed because at least you are there by their side, and its so compelling to think that she could actually sleep and we could all feel like normal people again… but i am so terrified to hurt her or sever her trust in me. We are so bonded, the thought of breaking that code of communication that we share really freaks me out but i am a mess and fear for my health if i dont start sleeping through the night again soon. Should i tough it out for a few more months and see if teething eases up? She also just started walking, which is fairly early, so i sense that maybe this is contributing to her poor sleep. Prior to 6 months she was only waking once or twice for a quick feed and then going right back to sleep.. Any thoughts? Support welcome.

  20. Where to begin? As a mother of 2 kids under 3, I personally would never undertake any kind of “sleep training” until someone could show me valid evidence regarding the safety of such techniques. To me the definition of safety is a broad one. I want to know about the long term effects of elevated stress hormones in the brains of infants, I want to know about the ramifications on the mother/child relationship as observed by an independent party (looking at intangible elements such as trust), breastfeeding implications, long term efficacy of the methods and whether they required repetition over time, the link between infant sleep training and SIDS, the biological/evolutionary reasons behind why babies wake frequently and the long term impact of forcing them into unnatural sleep patterns.

    It is self evident that there a numerous and sizeable gaping holes in the research presented above and the writer acknowledges this – carefully – as an afterthought. In my opinion, it is therefore quite irresponsible to draw conclusions from the currently available ‘evidence’ (as sicenceofmum is doing), and to subject babies to sleep training without proper evidence of its safety.

    My instincts tell me that babies aren’t born with the ability to manipulate, that they are a bundle of instincts for a good few years. From what I’ve seen, nature usually gets it right and it’s only when we try to mess with it, that we lose in some way (though we may not know it at the time). If babies have needs, physical and/or emotional, in the day and/or night, it’s my job as a parent to meet them even if it is difficult, inconvenient or tiring. After all, who am I to decide that my child should be sleeping for 12 uninterrupted hours, when it’s obviously very uncommon for them to do so on their own? Especially when there is no research that adequately assess the risks in forcing them to do so…

    • I was shaking my head in agreement your whole reply!

      Why do we feel we need to make babies into adults. A 6, 9, 12 month old has no reason to manipulate you AT ALL! They know what they need and they ask for it. Period. You chose to become a parent, this means that you are now supposed to be selfless, and yes that does mean in sleep too. This is life. In other cultures this is completely normal and guess what, babies learn how to “self-soothe” and put themselves to sleep even though they bedshare and are worn on their mamas back all day.

      I understand sleep is so important. I work too. But this is not a good reason to force a baby to do something they are not ready for.

  21. I should qualify my above comments with the following information. My nearly 3 year old son was probably the worst sleeper I knew out of my extensive group of mummy friends. From the day he started teething (approx 4 months old), he has woken between 1 and 10 times per night and has taken between 1 minute and 3 hours to resettle. I have gone through chronic sleep deprivation, to the point where my hair has fallen out from the stress my body was under, so I get it – it’s damn hard! Yet I never once entertained the thought of putting him through “sleep training”. I would never do it to my child, as I simply don’t believe that ‘the end justifies the means’.

    I believe that by meeting his needs he will be a more confident and secure person, who trusts that in his moment of need, someone will be there for him, and that the risks associated with not meeting his needs are far worse than any physical challenges I might face. After all, I am an adult with many different coping mechanisms and the ability to rationalise. My focus became doing everything I could during the day, to cope with what was going on at night.

    I thought “The No Cry Sleep Solution” was wonderful and really helped, because it offered a gentle approach to helping babies to sleep. There are also other amazing books that have the same ethos (e.g. “Helping Babies to Sleep, Why Gentle Techniques Work Best” by Gethin and McGregor).

    I hate it when people say that parents should “do whatever works for their families”, because it ignores the potentially dangerous effects of the methods being employed to reach the desired outcomes. Just because something “works”, doesn’t make it good or right. Drugging your kids will also work in getting them to sleep, but you don’t find people openly recommending that.

    Maybe a shift in expectations is what’s really needed, maybe we could learn a thing or two from ‘less civilised’ cultures, who would probably find it strange to think that a young baby could sleep alone in a room for a 12 hour stretch, without any parental contact, and who would also probably struggle to understand the benefit in depriving a child of comfort when they are distressed. I don’t believe that any sane mother looking into the little red face of her tiny baby, while it is screaming and crying in distress, with tears rolling down its face, an elevated heart rate and maybe even banging its head against the side of the cot, could withhold comfort. Maybe it’s time we start going with that maternal instinct instead of listening to all the well meaning sleep training advice and just closing the door.

    • Pebbles, your many points are well-taken. Let me add a few things that I think also have to be considered here.

      Every decision we make, as a parent or otherwise, is a risk-benefit analysis. That may sound cold, but it’s true. Of course, we aren’t always good at recognizing both the risks and benefits, but lets assume we try our best. Every time we put our kids in the car, buckled securely as possible in their car seats, we are risking their lives and taking very serious risks. There is no research to show that driving a car is 100% safe. Yet, we continue to drive our kids around in cars because there are clear benefits even as we take those risks. We get to go to fun places like the library and the swimming pool. We get to accomplish errands and many other useful tasks. We get to visit friends and relatives. The benefits outweigh the risks, but that action is never without risk.

      For you, the risks of sleep training clearly outweighed the benefits, and you made the right decision for you. But for many parents, we can’t assume that NOT sleep training is without risks. You wrote that sleep deprivation compromised your health in a very tangible way. You may have been able to cope with that; others can’t, or at least not in a healthy way. I’ve written about all the serious effects of sleep deprivation here. The risk of driving on little sleep, the association with post-partum depression – these are very serious risks. Avoiding letting a baby cry at all costs? I’m not sure that that’s always the best or healthiest answer.

      Sleep is critical to babies, too. In your comment, you made the assumption that babies get the healthiest sleep when we respond immediately to their every cry, and I’m not sure we know that is true. I can understand why you would make that assumption, because it is instinctual to try to stop a baby from crying. However, one of the hardest things I’ve had to learn to do as a parent is to pause before reacting, to listen to my baby, and to give her a chance to calm herself before I do it for her. Who’s to say that babies aren’t capable of calming themselves? We’ll never know if we don’t let them try. And the truth is – and this IS supported by research – that even giving babies just a little time and space to try to self-soothe allows them to start sleeping for longer stretches. My observation of my own daughter was that after she learned to self-soothe (vs when she was struggling to fall asleep with my soothing and waking many times during the night), she got HOURS more sleep during the night, and she was more playful and attentive during the day.

      All of our experiences are different. Our babies are different, and we have different coping skills and abilities. For this reason, I stand by my assertion that parents should work to find a solution that will work for their families – not yours – so long as they do so lovingly, carefully, and respectfully.

      • You are right about getting into a car with children being a risk that we take every day, but we have a very clear understanding of these risks and are therefore able to make informed decisions and undertake our own EDUCATED “risk-benefit-analysis”. Can you clearly outline and quantify with statistics, the risks involved with controlled crying in the same way as with car travel? I don’t believe so.

        As Pinky McKay so eloquently puts it:

        “There’s a big difference between ‘No Evidence of Harm’ and ‘Evidence of No Harm'”

        As for “the assumption that babies get the healthiest sleep when we respond immediately to their every cry”, I don’t feel like I made that assumption or assertion at all. If anything I may have assumed that there might be a biological reason that babies wake at night (maybe comfort and parental contact at night are important to babies’ healthy physcho-social development), especially since most of them ARE waking at night. I also mentioned that that there may be potentially harmful effects of forcing babies into unnatural sleep patterns.

        As far as I understand, Attachment Theory forms the basis of modern psychology. I just can’t see how not responding when babies call out and cry for help, will foster good attachment with a caregiver.

        But hey, I’m not an expert in the field. Which is why I like to read what the Australian Association of Infant Mental Health (an affiliate of the World Association of Infant Mental Health), has to say on the topic of Controlled Crying:

        http://www.aaimhi.org/inewsfiles/controlled_crying.pdf

        and on the topic of Responding to Babies’ Cues:

        http://www.aaimhi.org/inewsfiles/Position%20Paper%202.pdf

        You wrote:

        “The risk of driving on little sleep, the association with post-partum depression – these are very serious risks. Avoiding letting a baby cry at all costs? I’m not sure that that’s always the best or healthiest answer.”

        From this I gather that you think there is no solution that involves both mother and baby getting a good nights’ sleep UNLESS the baby is allowed to cry. I simply don’t agree.

        I’m not for one minute suggesting that sleep deprivation to the point of compromised health is an acceptable state for a mother, or that I was able to cope with it any better than the next person. It was/is unbelievably hard. My point was that babies cry for legitimate reasons, and that there are strategies and methods that are gentle and respectful that can help babies to sleep without potentially compromising their sense of security and trust in their caregiver.

        • I’ve read the AAIMHI documents, and I’ve searched all their citations for references to specific short- and long-term harm that can come of sleep training. As far as I can tell, it is a theory, and one that many other professionals and experts do not agree with. As a mother, I have found Attachment Theory very helpful in building and understanding my relationship with my daughter. However, I’m not convinced that sleep training impacted the quality of our relationship or her trust in me, and I paid close attention to this throughout her development. I do think that a baby’s response to sleep training is highly dependent on the baby’s temperament, her degree of distress, her ability to cope, and her stage of development. I think that we have to be very sensitive to all of these factors.

          I don’t think that allowing babies to fall asleep on their own at night causes them to develop unnatural sleep patterns. Different sleep patterns, but not necessarily unnatural.

          And I don’t think that crying is the only solution, not by any means. After all of my study of this topic, I feel like there is decent evidence that a gradual approach with more parental presence is less stressful to baby. That doesn’t mean that this approach is right for every baby – that’s just my interpretation of the research (which, to be fair, is mainly on non-human primates, which don’t always respond to stress as humans do). Crying may not be the only solution, but many parents find that some crying is necessary if they are going to allow their babies to learn to self-soothe. The thing is, nobody likes sleep training, but we still do it because it is hard to get around the fact that if a baby is going to self-soothe, she has to have the chance to try it. And also, it works. I think it is an imperfect solution, but I have yet to find the perfect answer that will work for everyone. When I visit parenting forums on sleep, at least those with an anti-sleep training philosophy, what I find is a lot of commenters telling desperate parents to hang in there for another year or so (every waking is a chance to build attachment – or resentment, depending on your mental state). Or try herbal remedies (which doesn’t strike me as a risk-free or sustainable solution). I’ve heard from some parents who found “The No-Cry Sleep Solution” very helpful and others who said they tried 10 different methods from the book and nothing worked for their baby. So there are certainly other solutions, but many parents still find themselves without one that works, stuck in a perpetual cycle of rocking/bouncing/walking to sleep and having to repeat that routine throughout the night. These parents and babies need solutions, not judgement and guilt.

  22. So I think we can agree on one thing from all of this debate; that the choice to undertake sleep training is not one based on sound scientific evidence. That the research and evidence available on the topic is limited and of poor quality.

    Sleep training is usually a decision made by sleep deprived and desperate parents, whose rational judgment may be impaired due to exhaustion. I believe it is therefore risky and maybe a little irresponsible to propose sleep training as a scientifically backed solution (which is essentially what “science of mum” is doing), when in fact it is a completely non-scientific choice that parents are making, with unknown and unquantifiable risks.

    Furthermore, in assessing the impact of sleep training on a child, I don’t believe that the mother who originally chose to undertake the sleep training, is the best judge. As you stated:

    “…I’m not convinced that sleep training impacted the quality of our relationship or her trust in me…”

    I’m not convinced you are objective enough to make that call, or that you have an appropriate benchmark. Again, a completely un-scientific assessment.

    In terms of self soothing, isn’t that something that happens naturally once the child is developmentally ready? My son is now self soothing through the night at age 3 and I’ve never done any kind of sleep training. Do we insist that small babies learn to read Shakespeare or ride a bike before they can walk? No, because they aren’t developmentally ready.

    The argument that something is good because it works just doesn’t cut it for me. I made the point in my original post that drugging children also works, but is obviously not an advisable solution.

    What is abundantly clear is that people get very defensive when you challenge the decisions they’ve made around parenting children. My aim is not to judge or lay guilt trips on anyone, and I have the utmost compassion for those struggling with sleep deprivation. The point I’ve been trying to reiterate is that sleep training is a completely non-scientifically backed approach, that may or may not work, and that might also have unintended negative consequences.

  23. I am a little late joining the party… Our daughter was just born on Dec 4 last year and is now about 8 weeks old. We are researching sleep for infants to see options are out there. Alice, I have really enjoyed reading your posts.

    Pebbles, obviously in this forum your decision to reject any form of sleep training is respected. As a new parent, it is abundantly clear to me that every child is very different. What works for one, may not work for another. As such, parents must assess their individual child, as well as the family’s needs/goals, when deciding how to proceed with infant sleep. It seems to me that Alice has already made this position clear.

    One thing I would like to point out in reading your posts on this topic is that while you so strongly argue against sleep training due to the lack of research on its affects, you fail to recognize that the reverse applies to your theory as well. We also do not know the effects of responding every time the child cries or not allowing the child to have the opportunity to self soothe. It is my personal belief that a parent’s most important job is to prepare their child for the real world. A world where, for example, you do not get a trophy for participation. I feel there is some merit to allowing a child to learn how to self soothe (if they can) and I also believe there is the possibility that in NOT allowing the chance to learn self soothing, we are teaching our children that we will always be there in their times of distress, which is not physically possible as they get older. While we NEED to be there for them while they are little babies, if this behavior continues into toddlerhood/preschool, how will they know to cope when they are upset when you are not with them? It is much easier as a human being to learn to do something the right way than to try to correct it later. If they can learn to self soothe as an infant, why not allow them to? Otherwise, they may find themselves without those skills as a school age child.

    I am not asserting this theory to be true, but merely pointing out that there does not appear to be research supporting either position strongly.

    • Let me direct you to the proximal zone of learning. While I do agree that children do need to learn to regulate emotions, infants are not capable of learning it, so won’t.

      Also, do you really expect this skill to be learnt spontaneously with no input from the parent?

  24. ” of all the studies of sleep training, not a single one has identified a negative effect on babies’ behavior or relationship with caregivers.”

    Hmmm is that true? Pretty sure it isn’t.

    [5] Lupien SJ, McEwan BS, Gunnar MR, Heim C. Effects of stress throughout the lifespan on the brain, behavior, and cognition. Nature Reviews 2009; 10: 434-445.

    [6] Gunnar, M. R. (2006). Social regulation of stress in early childhood. In K. McCartney & D. Phillips (Eds.), Blackwell Handbook of Early Childhood Development (pp. 106-125). Malden: Blackwell Publishing.

    [7] Halligan SL, Herbert J, Goodyer I, Murray L. Disturbances in early morning cortisol secretion in association with maternal postnatal depression predict subsequent depressive symptomology in adolescents. Biological Psychiatry 2007; 62: 40-46.

    [8] Jones NA, Field T, Davalos M. Right frontal EEG asymmetry and lack of empathy in preschool children of depressed mothers. Child Psychiatry Hum Dev 2000; 30: 189-204.

    [9] Middlemiss W, Granger DA, Goldberg WA, Nathans L. Asynchrony of mother-infant hypothalamic-pituitary-adrenal axis activity following extinction of infant crying responses induced during the transition to sleep. Early Human Development in press.

    [10] Feldman R. From biological rhythms to social rhythms: physiological precursors of mother-infant synchrony. Developmental Psychology 2006; 42: 175-188.

    [11] Feldman R. Parent-infant synchrony and the construction of shared timing: physiological precursors, developmental outcomes, and risk conditions. Journal of Child Psychology and Psychiatry 2007; 49: 329-354.

    [12] de Weerth C, Zijl RH, Buitelaar JK. Development of cortisol circadian rhythm in infancy. Early Human Development 2003;7: 39-52.

    • Reading through this list of references, I see one that is about sleep training – the Middlemiss study. I wrote about it in my post on stress and sleep training. Many of the others you cite are about depressed mothers. In fact, sleep training has been shown to relieve postpartum depression.

      I think you can make a reasonable argument that the studies on sleep training haven’t done a great job of assessing effects on attachment and behavior, but they have tried, and none have found negative effects. You could call the asynchrony observed in the Middlemiss study a negative effect, but (a) in my view, there were a lot of problems with that study, so we have to be careful in our interpretation of it; and (b) it says nothing about the clinical or real-life significance of that one day of documented asynchrony. My guess is that we all have days of asynchrony with our babies. That’s life, and the beautiful thing is that we can recover synchrony and strengthen relationships despite it. And if your baby’s suddenly sleeping well because she learned some new skills in the process, then I’m not convinced that it’s a damaging thing.

      • So if a doctor prescribed you a medication and told you that there was no evidence that it caused harm, would you take it? Or would you require that he prescribe you a medication for which there was evidence that it caused no harm? How about if he prescribed you a medication and informed you that there was actually insufficient/inadequate research on its effects? Would you take it? Would you give to your kids?

  25. Thanks Chet, I was actually so baffled by Amanada’s post that I didn’t even know where to start in responding. Your knowledge of the research is appreciated.

    Amanda’s logic is so upside down. From my basic understanding of child psychology, the more you respond to your child with compassion and understanding, the better equipped they will be to regulate their own emotions once they are developmentally ready. Not the reverse.

    Providing babies with the reassurance and security that there is someone there for them when they are in need, makes them emotional ‘whole’ and not insecure. Like I said in my earlier post, you can’t teach an infant to ride a bike before they can even walk, or to read Shakespeare before they can talk, so why would people think that a tiny baby can self soothe when they are too psychologically and emotionally immature? It really just doesn’t make any sense to me…

    • I don’t disagree that it is important to provide babies with reassurance and security. My philosophy is that foremost, every child responds differently and has different needs. It’s important for the parents to assess what their individual child needs. I’ve heard of some babies who so fervently fight sleep training that they blow a blood vessel in their eye or vomit. Obviously, sleep training is not the right answer for these children. However, some, like Alice’s daughter, will in fact respond to sleep training when given the opportunity. With my daughter, we taught her to fall asleep in her crib by herself without a sleep prop other than a pacifier. We did this by going into her room every 2-3 minutes if she was crying and soothed her, sometimes picking her up for a minute or just laying a hand on her chest. If she cried like she was scared or distressed, we would not force it. If she was crying in protest but not out of fear, we continued, carefully watching and assessing her every step of the way. She learned very quickly to fall asleep in her crib on her own, a vital life skill, and everyone in our home now has harmonious sleep, and has since she was about 9 weeks old. She is no longer afraid to lay in her crib by herself. I’m not suggesting this will work for everyone. It is my belief that some infants can learn to self soothe, but it depends on the child and probably also how old they are. At three weeks my daughter was not very good at self soothing so we responded a lot more. As she got older, it got a little easier.

      I think comparing to responding or not responding to taking medicine is comparing apples and oranges… they are not the same.

      I don’t think my logic is “upside down”… If one is going to say they will not sleep train until there is more evidence, I think it is fair to point out there is also not much information on the long term effects of responding immediately every time. It seems to me that most parents who respond in excess to every cry without allowing the baby to try self soothing – even for a minute or two – end up with babies who cannot sleep alone or who don’t sleep through the night for a very long time. If that works for you and your family, then proceed that way. Just don’t pass judgement on those of us who do it differently.

      I believe this is a highly charged topic because all parents have had different experiences based on how their children responded. The bottom line is that we all do what we believe to be best for our child. My approach was to read everything I could and try various techniques until I found one that worked.

  26. You often refer to the skill of self-soothing. What do you mean by that? Infant mental health on self-regulation tells us that babies are unable to regulate their emotions in the first year. Even toddlers are not very efficient in this regard. It is in the preschool years that children start to be able to regulate their emotional states more effectively. In the first years, babies rely on their caregiver to manage their emotional arousals. They cannot bring themselves back to a place of calm. Yes, they may appear calm but only because they are no longer crying. (Even babies who were circumcised without pain medication appeared calm after they no longer cried, only now we know that they were in shock. Romanian orphanages engaged in various self-soothing and self-stimulating activities, they also no longer cried and perhaps appeared calm, but we know that they weren’t because they had very high levels of cortisol). Just because a baby no longer cries and perhaps suck his fingers (mind you later we will call thumb sucking a bad habit) we cannot assume that the baby achieved a sense of calm or centered herself. Do you really believe that after crying for several days each time your baby was put to bed, once she no longer cried, it was because she achieved a sense of calm and went to sleep as a result? I think it would be a more honest appraisal to say that you just could not deal with her sleep patterns and with her needs of soothing. I would never judge you for that but I get a little cringe when you try to justify sleep training as a way to teach calming techniques to your baby.

    • I think comparing any decision made by a well meaning parent to a Romanian orphanage where babies faced years of neglect is nothing but judgment. This sort of hyperbole is actually an incredibly vile attack on someone who doesn’t share your beliefs or interpretation.

      I see where the non-sleep training camp is coming from, and am happy they are raising their kids in a way they are comfortable with. The same courtesy should be extended to all informed and well meaning parents. The only thing I don’t get is the insistence that science prove a negative. No one can prove ‘no harm’ only ‘no evidence of harm’. Heck, if ‘no harm’ is your burden of evidence, you best stop drinking water or prescribing any medication because science isn’t capable of proving a negative yet.

      • I didn’t actually compare CIO with neglect of Romanian infants. The comparison was related to self-soothing of infants, whether in complete neglect or sleep trained. Some of the behaviours, such as not crying out and self-soothing, are similar. This mom is obviously very conscientious and devoted and her daughter is raised in the context of a loving environment.

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  28. Thank you so much….for providing a bibliography! The article is great, and I appreciate the scientific approach, but I REALLY appreciate providing the actual sources from which your information came. As a parent one always tries to find the ‘best’ approach, which seems impossible to do when hundreds of people have opinions and ‘studies show’ examples, yet they fail to list where they actually got the info. I am astonished at how difficult it has been to just get straight information on these studies. So thank you, it helps me to make an INFORMED decision instead of a well-Carrie-down-the-street-thinks-this-might-work decision.

  29. Love the scientific approach of your writings.
    My baby is now 12 weeks old and has sleep trained well.
    He started in the bassinet/crib beside our bed.
    First I got him in the routine of going to bed every night at the same time – 7pm – after bathing and massage, I spent an hour in a dark room with him and nursed him to sleep and let him suckle.
    He was waking up every two to three hours at this stage.
    Then at 7 weeks I moved him into his own room where I could see and hear him on the monitor.
    I set the volume so I could hear the loud crys but not the quieter fussing.
    When he woke in the night I let him fuss for a few minutes before going to him and made sure he was fully awake so he would feed well.
    He quickly reduced his night feeds to 1am and 4am – waking for the day at 7.30am.
    To make up for the reduced feeds I fed him on demand through the day, increasing his caloric consumption.
    At 10 weeks I started sleep training him for his day naps.
    Prior to this, after he woke from each nap, I time 1.5 hours or wait till he gets grizzly and stops focussing then would use a swing to get him to nap for as long as he felt like it.
    He had become reliant on the swing as a sleep aid but I also noticed that it was making him constantly crave motion and he found it more and more difficult to relax and be still.
    To train him to sleep in the bassinet at nap time, I put him in his sleep suit, gave him a kiss and left the room.
    The first few naps i let him cry cold turkey without helping him to sleep.
    I think he needed this as he had become so reliant on me, the swing or the pram helping him to get to sleep.
    If I was in the room the cries would just escalate.
    On the third day, i started comforting him with a belly rub every few minutes when his cries sounded emotional.
    Myself and our two dogs also napped in the same room to reduce his stress at these times.
    I noticed that he did not cry real tears when I stayed and he then started going straight off to sleep.
    He became a much happier child after sleep training and was able to regulate his own behavior during wake times more easily.
    During daily activities such as bath time, pram time and lying on his mat he was slower to cry.
    Also and his attention span was longer as he was more well rested.
    He smiled more and was more loving towards myself and my husband.
    The whole family are now happier and healthier.

  30. I am a single mother and have been the sole caregiver for my son since birth. I was worried about maintaining my milk supply with working full time and was thrilled to find out that “bedsharing” was actually quite acceptable. I loved having him in bed with me, he loved being in bed with me, and the whole night process was a breeze. I found this choice best since I am the only person to get up with him, however he has always woken up every 2-3hrs. He is now almost 6 mos. and I have become so sleep deprived, even with the bedsharing being successful, that I have decided to have him sleep in his crib, with the hope that we both can get JUST ONE night sleep. Lol so last week I started the sleep training. In ignorance I laid him down asleep, only to have him wake up immediately and start screaming. I wanted to try the unassisted cry it out until an hour and a half into it, for two nights, we were both crying and there was no consoling either of us. Finally I thought, if I were him, what would I want my mother to do? So 3 nights ago we began a more gradual approach. I laid him down awake, happy, and full. He started screaming immediately again, yet I never left his side. I would pat his bum and offer the paci, which he doesn’t take anyway, and a little stuffy to squeeze, and sing or console him. An hour into it the first night he finally crashed. Last night it took 20 mins. Tonight he went to sleep with hardly any fussing at all. He’s still waking very frequently, but I truly think we are moving in the right direction. Basically, he is crying it out, but I’m not leaving him alone for a single second. I’m hoping that well get to a point where I can lay him down sleepy and he’ll cuddle up and put himself to sleep. I’m also hoping that he will be able to do the same during the night. Especially now that I know he CAN last the night without a feeding. I’d love to get some feedback. I just loved these articles and their integration of statistical research, no matter now small their subject groups : )

    • Hi! I’m gonna try this. I just wrote a comment myself about my situation :) then I read your post. You say that you work full-time. Before you started the sleep training, how was your little one doing in daycare while you are at work? Thanks for any feedback

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  32. Hi, I enjoyed reading your article. The issue or concern that I’m having with my almost 9 month old boy is the following: and was wondering if you can help me. The baby & I bed share 100% of the time since his birth (except for before he could roll I’d co-sleep. (He had his own small crib beside my bed) I still breastfeed. Now what is worrying me very very much is when he starts going to daycare in just 3 or 4 months. If he is not sleep trained and cannot self soothe, the caregiver may have a very difficult time putting him down which will disrupt the other babies and I don’t want my baby to be crying and not be able to fall asleep while I’m not there. He will be miserable. I’m trying to leave him in his crib sometimes for naps but he gets very upset. I haven’t done it enough because someone lives above me & underneath me and it’s not well insulated so I’m worried to disrupt the neighbours any further. I’m not being consistant with sleep training because I can’t due to the not so tolerant neighbours. Is there any way to work around this? Can I simply keep bed sharing and once he gets to daycare he will learn to self soothe on his own? Thank you for any insight! :))

    • Hi Tina – Glad you read Sarah’s approach, and I hope that works for you! Once he’s falling asleep with you by his side, you can try gradually backing up a bit, maybe sitting in a chair so you are in his view but not actively patting, etc. He’ll get the hang of it. It sounds like this is worth trying for naps as you prepare for your transition to daycare. It may help him to nap well at daycare, and in my opinion, this is SO important! Otherwise you pick up an exhausted overstimulated baby at the end of your workday. I was also going to suggest that you chat with your childcare provider about this transition. He or she probably has a lot of experience with helping babies nap who come in with different expectations about naptime. She might be able to make some suggestions for how you can prepare for the transition. Also, many babies quickly adjust to different expectations at daycare and still nap well, even if it isn’t what they are used to. A good daycare provider will have some strategies to try. It also helps that daycare is exhausting for a baby – he may be really ready for naptime and figure out what to do quickly:)

    • I think you can continue to bedshare and help him to sleep if you want to. How they sleep at home don’t seem to relate to how they sleep at daycare. (http://www.ncbi.nlm.nih.gov/pubmed/21651607 you have to see the data in the article to conclude that there is no relationship between home or daycare sleep) You can sleep train and he may still have difficulties at daycare. He will work out the attachment relationship with the daycare provider and that may be entirely different than at home. You may want to make sure his needs are attended at daycare (including sleep needs) if this is important for you.

  33. Pingback: Why I Let My Son Cry It Out And Why I Would Do It Again | Intuitive Parenting

  34. I wake up on my own through the night to change my son’s diaper. He has yet to ever wake me up. I hated my life before bed sharing. I was exhausted, cried a lot and felt like a zombie. Now I am happy and enjoy my baby boy.

  35. I have an almost 6-month old daughter who slept in her crib from birth, and slept through the night from about 8-16 weeks (usually 8-10 hours a night), and then she stopped which we expected (we kept hearing about the 4-month sleep regression). From 16 weeks until last week, I would nurse her sleep (usually by 8pm), put her in her crib, and she was up at 10:30pm (just wanted someone to come in and pick her up – would go right back to sleep), and then up again usually around 2 to nurse. She recently got sick, then started teething, I got mastitis – so we’ve been bedsharing. She seems to nurse more for comfort in the middle of the night with 2-3 actual nursing sessions, but is in bed and sleeping more or less for about 9 or 10 hours a night. At some point we do want to transition back to her crib but my husband and I are not cry-it-out type people. Do you think I’m doing a disservice now by bedsharing (safely) – will it be harder to sleep train if we end up going that route? Would love your feedback! I think another few weeks of bedsharing might be all we can do – while I find that I’m sleeping more total hours than before, I am frequently disrupted by a fidgety baby!

    • You know, sometimes we get in patterns with babies that we don’t intend to be permanent, and at some point we have to make a change. Change is always hard, but babies can handle it. Sure, bedsharing now when it isn’t something that you plan to do for long might cause a little distress when you ask your baby to sleep on her own again, but it’s also helped you get through a tough period. And you’re already doing it, so I wouldn’t fret too much about it, so long as you are taking care to be safe. When it isn’t working for you anymore, then you can start putting her into her crib, but you can ease that transition by sitting next to her while she falls asleep, etc. It probably won’t be any easier to make that change now than in a few weeks.

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