Key takeaways: Behavioral sleep methods like graduated extinction and bedtime fading can improve infant sleep. Long-term studies haven’t found harm to attachment or emotional health. Sleep training is a family choice, usually considered after 4 to 6 months. Consistency matters more than the method.
Few parenting topics spark as much debate as sleep training. Some parents swear by it; others worry it’s harmful. Here’s what the research shows.
What Is Sleep Training?
“Sleep training” refers to behavioral approaches that help babies learn to fall asleep independently and resettle between sleep cycles. Methods range from more to less hands-on.
Common Methods
Graduated extinction (“Ferber” or check-and-console): put your baby down awake, leave, and check in at gradually increasing intervals, offering brief comfort.
Bedtime fading: temporarily move bedtime later to match when your baby naturally falls asleep, so they fall asleep quickly. Then gradually move bedtime earlier.
Chair method (camping out): sit next to the crib as your baby falls asleep, then gradually move the chair farther away over several nights until you’re out of the room.
Pick up, put down: pick your baby up to calm them, then put them down awake, repeating as needed.
Full extinction (“cry it out”): put your baby down and don’t return until a set time, except for safety or feeds.
What the Research Shows
- It can work. A randomized trial found that graduated extinction and bedtime fading reduced how long babies took to fall asleep and how often they woke, compared with a control group.
- No long-term harm found. A five-year follow-up of a randomized trial of behavioral sleep interventions found no differences in children’s emotional or behavioral problems, stress, or the parent-child relationship.
- Stress hormones: some studies have looked at infant cortisol; the randomized trial above found no meaningful increase.
- Parental mood: improved infant sleep has been associated with improved parental mood in several studies.
Research has limits. Many studies are small, and results apply to healthy babies over about 6 months. The evidence doesn’t show that sleep training is necessary, and many babies learn to sleep without it.
When to Consider It
- Most experts suggest waiting until at least 4 to 6 months.
- Your baby should be healthy and gaining weight well.
- Talk with your pediatrician about night feeds; many healthy babies over 6 months no longer need them, but some do.
Before You Start
- Set up a consistent bedtime routine.
- Make sure your baby’s sleep space is safe.
- Agree on a plan with all caregivers.
- Choose a method you can be consistent with for 1 to 2 weeks.
- Avoid starting during illness, travel, or big changes.
You Don’t Have to Sleep Train
Many families choose responsive settling, or simply wait for sleep to consolidate naturally. Some combine approaches. The best plan is the one that works for your baby and family, and that you can be consistent with.
Talk to your baby’s doctor if: your baby snores loudly or has breathing pauses, isn’t gaining weight, seems ill, or if sleep problems are affecting your mental health.
The Bottom Line
Sleep training methods like graduated extinction and bedtime fading can help, and research hasn’t found long-term harm. But it’s a personal choice, not a requirement.
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Sources
- Gradisar M, Jackson K, Spurrier NJ, et al. Behavioral interventions for infant sleep problems: a randomized controlled trial. Pediatrics. 2016;137(6):e20151486.
- Price AMH, Wake M, Ukoumunne OC, Hiscock H. Five-year follow-up of harms and benefits of behavioral infant sleep intervention: randomized trial. Pediatrics. 2012;130(4):643-651.
- Mindell JA, Kuhn B, Lewin DS, Meltzer LJ, Sadeh A. Behavioral treatment of bedtime problems and night wakings in infants and young children. Sleep. 2006;29(10):1263-1276.
- Hiscock H, Bayer J, Gold L, Hampton A, Ukoumunne OC, Wake M. Improving infant sleep and maternal mental health: a cluster randomised trial. Arch Dis Child. 2007;92(11):952-958.
- Paruthi S, Brooks LJ, D’Ambrosio C, et al. Recommended amount of sleep for pediatric populations: a consensus statement of the American Academy of Sleep Medicine. J Clin Sleep Med. 2016;12(6):785-786.
This article is for general education and is not a substitute for individualized medical advice. Always talk with your baby’s health care provider or your own provider about your specific situation. If you think your baby or you may have a medical emergency, call 911.
