Sleep Training Baby: Dr. Weissbluth Sleep Training Method

While rolling over, walking, and talking are important developmental landmarks for all babies, getting them to sleep through the night is a critical step forward for parents!

Most new parents would give the world for a good night’s sleep, but do not know how to get there. You can help to promote your baby’s development of good sleeping patterns and encourage your baby to sleep through the night.

When your newborn is a few days old, the main problem is often that his or her daytime sleep and nighttime sleep are reversed. This is not surprising. Many babies come out of total darkness in utero, into a hospital delivery room and then nursery, where the lights are on 24 hours a day.

Most babies can adjust to a day and night schedule on their own in two or three weeks, but that is a long time for tired parents to stay up all night! To help shorten your baby’s adjustment period, first, minimize stimulation at night.

Feed, burp, change, and hold your baby quietly, quickly, and in the dark. During the day, try to keep your baby awake and active for 20 minutes after each feeding by changing positions, moving around, and providing visual stimulation and a variety of sounds.

Important: Read our guide on safe cosleeping with baby.

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Generally, babies of average size sleep for three hours between feedings at night (four if you are really lucky), and nurse every two to three hours during the day. It is a rare baby that can accommodate to the proverbial “four hour schedule.” It also helps to remember that “three hours between feedings” is calculated from the beginning of one feeding to the beginning of the next. Given that in the very beginning, feeding, burping and diapering may take nearly an hour, that leaves you with barely two hours of sleep at a time.

Once your baby gets on a more reasonable schedule of waking two or three times a night (that is between 8pm and 6am), you are in better shape. Nevertheless. you may still be in for a fairly long haul before you get a full night sleep.

Some babies start sleeping through the night on their own around three or four months. But most babies need at least one night feeding for quite a while longer.

Some babies are just plain ravenous! If your baby seems hungry both during the day and at night, he might still really need that 2am feeding. However, if your baby is unusually hungry only at night, then it is likely that he is waking for your company and comforting — not the calories.

A good time to begin a “going-to-sleep” routine is when your baby is “settled in” — about three months old.

1. Dr. Marc Weissbluth’s Philosophy on Sleep Training Baby

Dr. Marc Weissbluth takes a long-term approach to sleep training. He believes healthy sleep affects a child’s overall health, including his ability to learn.

He says parents can help children avoid long-term sleep problems by paying attention to infant sleep needs. The plan requires parents to watch for baby’s natural sleep cycles and then help him get the rest of the way there.

Dr. Weissbluth is an advocate for consistent naps and early bedtimes, saying that babies who are kept awake late to accommodate parent schedules end up paying a price in long-term sleep deprivation. Dr. Weissbluth’s five components of healthy sleep include duration, consolidation (uninterrupted sleep), naps, timing and regularity.

What you have to do

• Look for that drowsy state where your baby shows less movement and his eyes are not as alert and sparkly, or your older baby smiles less and is less engaged. If you miss it (a window within a one-to-two-hour wakeful time), baby may become overtired, and it will become more difficult to help her sleep.
• Reduce stimulation, light, noise and activity.
• Soothe baby to sleep: Swaddle, nurse, rock, sing, massage or otherwise calm your baby. Most babies need only one of these, and too many at once may be overstimulating. However, a colicky baby may require longer effort and more techniques.
• If your 0-to-4-month-old baby continues crying, don’t ignore the cries. Continue soothing him.
• It’s okay to put baby in bed during the drowsy-but-awake state. But if he falls asleep during the soothing, do not wake him before placing him in the crib. (Weissbluth seems particularly irritated by books that suggest otherwise.)
• Do not rush in at the first sound baby makes. Often baby will fall back to sleep on his own.
• Other key components: Be consistent with nap times and bedtime routines. Don’t interrupt sleep to feed or play with baby, and don’t keep him up late to adapt to your schedule.

Note: The above sleep training methods are intended to prevent sleep problems. Dr. Weissbluth suggests that 27 percent of babies still have difficulty sleeping at four months of age and require treatment in order to become healthy sleepers. If your baby falls into this category, Dr. Weissbluth’s book offers a myriad of “no cry,” “maybe cry” and “let cry” solutions, depending on your circumstances.

What you might like about the technique

• Like Dr. Sears’s, Dr. Weissbluth’s model encourages you to tune into your baby’s needs and respond accordingly, which reinforces the parent-baby bond.
• The theory acknowledges the inherent differences between babies and offers a variety of baby-centered approaches to resolve sleep problems ‑- rather than just one way.

Drawbacks

• The strong emphasis on consistent naps and early bedtime routines might be difficult for some busy families to adhere to.

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2. American Academy of Pediatrics

Philosophy

At about six to twelve weeks of age, your baby should begin to sleep for stretches of five to six hours at night, according to the American Academy of Pediatrics (AAP), but many babies need a nudge in order to make the transition from needing your help.

The AAP guide suggests that it’s important for babies to learn to soothe themselves to sleep, because everyone (adults included) goes through a series of sleep cycles that include arousals and wakings. A baby who learns to comfort himself will be able to quickly fall back asleep during one of these cycles.

What you have to do

• Maintain a predictable routine for naps and bedtimes.
• Starting at approximately six weeks old, put baby in his crib while he’s still awake. Let him get drowsy, but sing, tickle his toes or otherwise distract him so he doesn’t actually sleep until he’s in his crib.
• Keep the room dim and quiet, and give baby a soft toy or blanket if it helps.
• Don’t go in when baby first starts to cry. Wait a few minutes to see if he falls asleep on his own. If crying persists, go to comfort him, but do not pick him up. Comfort baby by speaking in a low voice and patting him gently. After he calms down, leave the room.
• If baby wakes up in the middle of the night, don’t rush to the crib. If crying continues, go in to comfort or change him. Leave as soon as he calms down.

What you might like about the technique

• This plan aims to help your baby learn independent sleep habits early on.
• A baby who can soothe himself back to sleep is less likely to become fully awake during an arousal state than a baby who depends on your help. The theory is that these babies get more consistent sleep.

Drawbacks

• While the AAP suggests that babies who know how to comfort themselves back to sleep usually do so in a matter of minutes, it can take a few nights of crying before they learn that skill.
• Many babies (and even moms) are reluctant to give up the luxurious habit of nursing or rocking to sleep.
• Some believe that a baby’s need for reassurance and intimacy is greater than his need to learn independent sleep habits.

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3. Dr. Richard Ferber Approach to Sleep Training

Philosophy

Dr. Richard Ferber’s sleep training method is rooted in the basic American Academy of Pediatrics theory that babies need to learn to soothe themselves to sleep in order to get the best sleep possible.

However, Dr. Ferber offers a more structured plan for babies who are six months or older and are still relying on what he terms “parental sleep associations,” like rocking or nursing. It’s a gradual but strict technique for shifting from parental soothing to baby self-soothing.

Contrary to popular belief, Dr. Ferber does not say that picking up baby is “spoiling her,” nor does he advocate leaving baby alone to cry it out without any parental intervention.

What you have to do

• Find a nighttime routine that helps calm your baby and signals bedtime. For instance, bathe, read a story and cuddle her.
• If baby is still nursing in the middle of the night, begin by replacing that feeding with rocking to sleep or some other parental association, before beginning to help her find her own way to sleep.
• Each night, put baby in her crib while she’s still awake. Sleep where you can easily hear her, but not in the same room. (Many parents take turns camping out on the couch during “Ferberization.”) When you go in at scheduled intervals, don’t pick baby up to rock or feed her. Instead, let her hear your voice, and rub her back or tummy. Stay only two to three minutes each time you go in to comfort her. Modify the schedule below to suit your own comfort level.

1. Day one: Let baby cry for five minutes before going in to offer comfort. The next time, wait 10 minutes, and then 15. If baby is still crying after 15 minutes, keep the interval at 15 minutes for the remainder of that night until baby falls asleep.
2. Day two: Let baby cry for 10 minutes before going in, then 15, then 20. Keep interval at 20 minutes until baby falls asleep.
3. Day three: Let baby cry for 15 minutes, then 20, then 25. Keep interval at 25 minutes until baby falls asleep.

Most children will be sleeping well by the end of three days and should definitely respond to the training by the end of a week. If not, speak with your pediatrician.

What you might like about the technique

• Short-term pain, long-term sleep: Most babies learn to soothe themselves to sleep after only a few difficult nights.
• Some experts and parents believe that helping a baby learn to sleep on her own is an important step toward independence.
• The method is highly successful in reducing nighttime wakings so that everyone in the home tends to sleep better.

Drawbacks

• It’s not for the faint of heart. While a few days might not seem like a long time to tolerate your baby’s cries, many parents find it almost impossible to stick to the schedule.
• Dr. William Sears says that any “crying to sleep” method encourages a mother to be desensitized to her baby’s needs, and that it is more important for babies to be reassured by responsive parents than it is for them to learn self-soothing during the first year.

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4. Dr Harvey Karp

If your newborn is part of the one out of four babies who suffer from colic, Dr. Harvey Karp’s book offers a practical plan to calm the crying and help baby sleep longer.

After studying colic worldwide and discovering it is absent in some cultures, Dr. Karp arrived at what he calls the “Missing Trimester” theory. Newborn humans, he says, are less mature than most newborn animals (cows and horses walk the day they’re born!). He surmises that babies are pushed from the womb before their bodies mature fully, probably because of the large human brain.

Colic, according to Dr. Karp, is actually a sort of “homesickness” for the womb. Why no colic in some cultures? The author says that in certain countries (Bali, for one), babies are given much more of a “fourth trimester” experience than in the U.S. Dr. Karp’s methods are devised to help you do the same by recreating the sensations of the womb.

What you have to do

Follow the “Five S’s” to recreate a womblike environment and calm your baby.

• • Swaddling: This lets baby know you’re preparing to take care of her.
• • Turn baby onto her side or stomach: Do this while calming baby, since this is how she likely feels most secure (but when you place baby in her crib, put her on her back as the American Academy of Pediatrics recommends to avoid SIDS).
• • Make soothing “shh” sounds: Loud white noise imitates what baby heard in the womb. Use your own voice or a hair dryer, vacuum or other appliance.
• • Swinging: Since babies are constantly bounced and jiggled in the womb, movement ‑- particularly tiny, vigorous movements ‑- says “home” to them.

• Sucking: In the womb, baby could reach and suck fingers easily. Therefore Dr. Karp suggests introducing a pacifier for the first four months of baby’s life.

What you might like about the technique

• Dr. Karp takes on the challenge of the most reluctant sleepers.
• The methods are simple and easy to implement.

Drawbacks

• This strategy addresses only those first few months ‑- not much help when you’re trying to get your nine-month-old to finally sleep through the night.
• Some parents fear that introducing a pacifier will encourage dependence on it later.

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5. Dr, William Sears

“Gentle to sleep” is one aspect of attachment-style parenting. According to Dr. William Sears, a baby’s wants and needs are pretty much the same thing during the first year of life. With this technique, prepare to adopt a “nighttime parenting style.” Rather than trying to teach baby to sleep, parents make sleep an attractive place for baby to be. This is accomplished by sleeping close (keeping baby in a family bed or in a bassinet nearby) and offering a number of comforting methods when she awakens.

 

What you have to do

During the day: Carry baby in a sling and cuddle often. Maintain consistent nap times and bedtimes. By fulfilling baby’s daytime needs for routine and closeness, you will help her develop more consistent nighttime patterns.

Before bed: Use one of a number of calming-down methods depending on your circumstances ‑- bathing down, massaging down, nursing down, fathering down (infant’s head nestled in crook of Dad’s neck), rocking down, wearing down (as in wearing baby in a sling, not horseplay), motoring down (yes, in the car).

Once baby’s asleep: Don’t sneak away until she’s in deep sleep. Look for limp limbs. Baby will often awaken if you set her down during the first stage of sleep.

During the night: Sleep close to baby so you can continue to monitor her needs. (If you use a family bed, make sure to read current precautions.) Comfort, rock, change or nurse baby when she awakens.

 

What you might like about the technique

 

• It encourages parental bonding. This is often especially satisfying for parents who spend much of the day away from their children.

 

• Many women develop a rhythm of sleep patterns that mirrors their baby’s.

 

• Unlike “sleep training” methods, parents can begin these techniques when baby is a newborn.

 

• Most parents find it easier and more convenient to respond to baby’s nighttime needs if baby is in the same bed or at least in the same room.

 

• There is no period of time during which you are instructed to let your baby cry alone in a room.

 

 

 

Drawbacks

 

• Babies don’t become self-soothers under this method, since they associate falling asleep with parental care.

 

• Some experts and parents believe that babies sleep more soundly and awaken less often when they learn to fall asleep without parental help.

 

• No rest for the weary! Some parents feel the need for more independent sleep themselves

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Into the Crib Awake

Many young infants are accustomed to falling asleep at the breast or while being rocked in a parent’s arms. This works well for the first two to three months. But between three and four months, it is very important to start putting your baby down in the crib awake every time she goes to sleep. She needs to learn to fall asleep on her own.

Do not put your baby to sleep with a bottle. It can cause tooth decay and dependence on feeding as a way of going to sleep.

Go through your bedtime routine (see below), then swiftly and smoothly put the baby in the crib and say your “good night.”

If your baby really fusses, stay with her until she goes to sleep but try to use just your voice to calm her down. If she gets really mad, you can try to pat her back, and if that does not help, pick her up, soothe her for a couple of minutes and put her back down in the crib, still awake.

Don’t let her fall asleep in your arms! This can be very trying with some babies. You may have to repeat the “picking up-soothing-putting down” routine over and over, for up to an hour on the first night. It’ll be much easier on subsequent nights.

If you start sleep training baby early enough (three months) and you first get your baby attached to a transitional object, he’ll learn to fall asleep in the cribs fairly easily.

This is critical: learning early how to fall asleep in the crib will enable the baby to go back to sleep by himself in the middle of the night later, when he no longer requires a nighttime feeding. If the baby is accustomed to falling asleep in your arms at bedtime, he’ll need you in the middle of the night, too.

A “Going to Bed” Routine

Start establishing a very simple, consistent “going-to-bed” routine, such as bath, diapering, nursing or bottle, a kiss, a song and “into the crib.” The importance of this routine is that it establishes a predictable set of events which will help your baby “unwind” and get ready to go to sleep.

When you wean your baby, gradually replace the feeding with cuddling, a brief bedtime story or song, or saying good night to the moon and the stuffed animals in the room.

The Middle of the Night Routine

If you have done all the “preparatory work” and your baby does not start sleeping through the night on her own by the time she is seven months and weighs at least 14 pounds, you can start the “sleep routine training.”

Similarly, if your baby did sleep through the night for a while and started waking up again (a very common occurrence), start the sleep routine. However, if your baby starts waking up after having slept through the night, first, ask yourself what is going on in her life.

Any of the following events, and other similar changes, can cause sleep disruption:

• Changes in the family’s routine, such as a trip, someone’s absence, an illness, a move to a new house or a new room, or even rearranging the baby’s room and crib
• A new separation from mother or father
• The onset of “stranger anxiety” (usually around eight to nine months)
• Teething
• Starting to crawl or walk or other major developmental advances
• Visitors staying at your house.

If any of these changes has occurred, you must first address the new situation. With an illness or teething, wait for it to pass. With changes involving separation or greater mobility, allow some time for adjustment and increase your physical closeness during the day.

Eliminate Nighttime Feeds

If your baby has been breastfeeding at night, you can try to have your partner comfort him in the middle of the night.

The sleep routine is simple and effective, but it is often very hard for the first few nights. One of the parents (preferably the father or non-nursing partner, if the mother is nursing) sleeps in the baby’s room for a few nights. Whenever the baby wakes up try to get her back to sleep by just using your voice, saying something along the lines of: “I am here, go back to sleep.”

If the baby is very upset, you can try patting her back along with talking. If that does not work (i.e. another ten minutes of real crying), pick up your baby and soothe her in your arms (no breast or bottle, though). When she calms down, but before she falls asleep in your arms, put her back in the crib. This may create the “yo-yo effect” — you’ll be picking your baby up, soothing her and putting her down to renewed howling, over and over.

Do not despair: This is the essence of the “training” — reassuring your baby that you are there to comfort her, but insisting that she fall asleep in her crib Eventually your baby will fall asleep.

It’s a good idea to keep a clock that you can see in the dark in your baby’s rooms. That way, you can see how much time has actually gone by: It will seem like hours! Keep a log of how long it takes your baby to go back to sleep each time, and how many times she awakens at night. The log will help you see the progress you are making and most likely you won’t be needing it after a week.

The sleep routine is not a remedy “once and for all.” You do it every time your baby starts waking up at night. Most infants and toddlers have recurrent periods of sleep disruption due to illness, changes, the separation process and other anxieties. Each baby is different and each circumstance has its unique features: These suggestions are general guidelines, not a “recipe.” If you find that the suggestions outlined here do not work for you and your baby, you should seek professional guidance and counseling.