A parent’s guide to sleep training infants and toddlers

Sleep training is a commonly misunderstood topic among new parents.

But with proper preparation and consistency, it can be a valuable asset in improving overnight sleep for both you and your child.

Below are answers to frequent questions I get from parents.

What is sleep training?

Sleep training involves giving your infant, toddler or child the tools they need to fall asleep at the beginning of the night and back to sleep in the middle of the night without parental intervention.

A common misperception is that sleep training is teaching your child to sleep straight through the night. That's untrue. Even we adults wake up multiple times at night. This is part of the process as we cycle from one sleep phase to the next.

Sleep training your child is more about helping them develop the independent skills they need to fall back asleep.

What is the best age and weight to start sleep training your baby?

The best age and weight to begin sleep training varies, since every baby develops differently.

Your child’s pediatrician can help you decide when the time is right. In general, 4 months and 14 pounds is a good time to start.

Babies do not actually develop their own melatonin or regulation of their sleep cycles until around 3+ months. Up to then, their ability to fully distinguish between day and night and connect sleep cycles to night is limited.

Generally, 14 pounds is a good weight because the baby may not need overnight feedings at this time.

What is the best sleep training method?

The best sleep training method is the one you and your partner can maintain until the pattern becomes habit.

For example, many families try the cry-it-out method, where they let the baby cry without intervention or overnight feeds. You often see results quickly with this technique but some parents wind up intervening every now and then.

Inconsistency can stop any progress being made. Your baby is looking to learn and needs to understand what to expect.

So the right method is the one where you and your partner, if a partner is involved, can find a routine and be consistent.

How long does sleep training usually take?

This can depend on the baby and the chosen method, since each baby is a little different.

In general, the cry-it-out method tends to work in as little as three to four days.

The Ferber method, also known as "graduated extinction," usually takes somewhere between seven to 10 days. In this case, the parent comes to check on the baby at longer intervals over time.

More lenient methods can take up to four weeks. These include the chair method, where a parent sits in a chair by the crib/bed at night until the child falls asleep. The parent gradually moves the chair further away nightly so the baby learns to fall asleep with less interaction.

Will sleep training harm my child?

When done with the right preparation and in the right environment, sleep training is safe and effective. In fact, the benefits to children and parents are major.

For instance, The American Academy of Pediatrics conducted a study where infants were divided into two groups. One group went through sleep training, the other did not.

The study measured:

• Cortisol levels – a key marker of stress - in the baby
• Parental satisfaction and stress levels
• Attachment styles once the baby reached 1 year of age

Results found that babies in the sleep training group had decreased cortisol levels by the end of the training. And there was no difference found in attachment style or behavioral problems between the sleep trained group and the non-trained group.

Sleep training can help babies learn how to self-soothe and cope with stress experienced whether parents intervene or not.

Can I sleep train my toddler?

Sleep training a toddler may look different from sleep training an infant, but it’s possible and beneficial.

It can be more difficult for a toddler because they have a voice and they can get up and leave the bed. The cry-it-out method may not work.

However, toddlers understand rewards and motivation. Get their buy-in and use positive reinforcement, like saying, "If you stay in your bed without getting up at night, you get a sticker.”

That kind of praise for accomplishing a task is really motivating to them.

When should you contact your child’s pediatrician about sleep training?

If you’re interested in sleep training, bring it up to your child’s pediatrician first.

They can ensure the baby is ready, healthy, and does not need those overnight feeds.

They can also answer any questions or concerns before or during the training process. Your pediatrician can help make sure your baby is thriving and growing.

*Angela Holliday-Bell, MD, is a UChicago Medicine Medical Group provider. UChicago Medicine Medical Group is comprised of UCM Care Network Medical Group, Inc. and Primary Healthcare Associates, S.C. UChicago Medicine Medical Group providers are not employees or agents of The University of Chicago Medical Center, The University of Chicago, or UChicago Medicine Medical Group - Homewood.