Sleeping through the night in three easy steps

The Pediatric Insider

© 2011 Roy Benaroch, MD

Sleep….what every parent of a young baby needs. And ironically, if you’re not getting enough sleep, you probably don’t have the energy to slog through any of the “help your baby sleep” books. Fortunately, we’re here to help. You want to teach your baby how to sleep through the night? I’ll tell you the three necessary steps. Do this, and you and your baby will soon get a good night’s sleep, or at least get closer—sorry, no guarantees here. Babies have their own plans, and their own personalities, and there is never a one-size-fits-all solution for everyone. Still, these ideas should help any baby get closer to a full, solid night’s sleep.

You can start these sleep-training ideas at any time. If getting a solid night’s sleep is a priority, the younger you start training, the better.

Step 1: Ensure that Junior is getting enough calories during the daytime. Think of it this way: he knows how much he needs in a 24 hour cycle, but he doesn’t really care if he eats more in the day or night. “Oh, don’t worry, Mom,” baby might say. “Don’t rush to feed me this afternoon. I’ll just wake you up earlier tonight!” As babies get to 3-4 months of age, they will be able to go longer between day feedings. Do not allow this. Don’t let them stretch out the day feeds until the night is one solid block of sleep.

Nurse frequently. During the day, if Junior is awake and it’s been more than 2 hours since the start of the last feeding, it’s time to eat again (if baby is asleep, wake at 3 hours past the start of the last feeding.)  Start solid complementary foods at 4-6 months (earlier is not better).

Step 2: Don’t react to every little noise babies make as they sleep. You will stir a bit, baby will fuss a bit, and then you’re both wide awake. As soon as you feel comfortable, move your baby to his or her own room so you don’t keep waking each other up. If baby wakes and makes a little noise, don’t rush in immediately. Take your time. At least sometimes, Junior will put herself back to sleep without your going to see her. Give her a chance to soothe herself!  If you must share a room, try to lie quietly when you hear your baby start to make noise.

There’s a persistent half-myth that bottle fed babies sleep better. I call it a half-myth because it is in fact true, but not true for the reason people expect. Bottle fed babies do sleep through the night faster—but that is because it takes mom several minutes to go to the kitchen, warm a bottle, etc. By the time she makes it to baby, at least sometimes the baby will go back to sleep. For nursing moms, it can be quick and convenient to get a feeding started—and that’s a good thing, most of the time. But if you’re trying to sleep train, don’t be so quick to begin nursing the moment your baby starts to wake at night.

Step 3: I saved the most difficult for last. It’s time to allow your child to learn that he can fall asleep alone. Parents usually end up holding their little newborns as they fall asleep,  which isn’t at all a bad thing. Newborns may genuinely need a close warm loved one to help them make the transition to sleep. But many parents neglect to allow their own habits to change as their babies develop. They continue to hold their babies as they fall asleep, never even giving them a chance to begin to learn how to sleep on their own. If you’re holding, rocking, or feeding a baby while he falls asleep, the baby—guaranteed—will wake up again later that night after you sneak away. He will need you to come back and resume holding, rocking, or whatever to ease him back to sleep.

The concept here is “independent sleep associations,” referring to the kinds of things we’re used to having around as cues to help us fall asleep. It would be very hard for most of us to fall asleep without a pillow—because we’re used to having a pillow when we fall asleep. And if someone were to steal your pillow in the middle of the night, you can bet you’d wake up quick. If your baby depends on you as a sleep association, she will not stay asleep if you leave the room. You’ve got to camp out all night. Maybe that’s what you want to do. But if you’d like to have your own nighttime for yourself and your spouse, you cannot be a sleep association for your baby.

I’ll make it simple with some good rules of thumb: by two months of age, you should sometimes be putting your baby down when awake; by four months of age, you should usually be putting your baby down awake; by six months of age, always put your baby down while awake. If you never try, it will never work. It does not get easier to start working on these independent sleep associations as babies get older.

So what do you do when your baby isn’t falling asleep on her own? Follow the plan, and keep it simple. Put your baby down with confidence and no apologies. Say “Good night, honey, I will see you tomorrow.” Then leave. Do not go and check every few minutes—that teaches your baby that hysterics will bring mommy in running. The lesson here is: it is night, you are in your bed. It is time for sleep. This is the way it is. Now, you cannot make a child sleep—but you can control your own reactions. When Junior learns that this is the way it is, the crying stops, and the sleeping begins. Keep in mind that the older your baby is when you start this, the more stubborn she will be, and the longer she will cry.

Is it cruel to let babies “cry it out”? I do not think so. There will be hundreds of other occasions each day when your baby wants you to do something, and you’ll do it right away; there will be dozens of times each day when you’ll quickly respond to crying with hugs and reassurance. There are genuinely times when tough love is needed. When your 2 year old wants a candy bar at Target, she’ll throw a tantrum when you say no. Your teenaged daughter will scream “I hate you!” when you refuse to let her spend the weekend in Panama City with her boyfriend. Letting your baby cry at bedtime is not more cruel than other times when saying “no” is the right thing for a parent to do.

In fact, it may be more cruel to not let your baby learn to sleep through the night. For parents, lack of sleep contributes to marital discord, stress, and depression. You’ll be less patient and less engaged with your baby during the day when you’re exhausted. Furthermore, if you’re not getting a good solid night sleep, then your baby isn’t getting good sleep either—which compounds the cranky. In the long run, parents and babies need to get their solid sleep at night. Parents who delay sleep training are preventing their children from learning an important life skill while making family life miserable. Who’s being cruel?

Some babies will make this easy. Other babies will fight sleep and make this a more difficult transition. Exactly when to sleep train is a personal decision, depending on the parents’ plans and priorities. But if you want to get your young baby sleeping through the night, you don’t need a great big book to read. You just need to follow the three steps above, consistently, every night. It may seem rough at first, but soon you and your baby will all a better night’s sleep.

A shorter version of this was originally published on WebMD.

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20 Comments on “Sleeping through the night in three easy steps”

  1. Rosomaqa Says:

    “You can start these sleep-training ideas at any time. If getting a solid night’s sleep is a priority, the younger you start training, the better.”

    I would like to point out that sleep-training is not a necessity. I’m getting a “solid night’s sleep” by co-sleeping and breastfeeding my 11-month old since she was born, and it was the same with my older daughter. Many of my friends swear by the same method. The baby “serves herself” while mom wakes for a second and goes right back to sleep. sleeps. I realize this is not for everyone – first of all, obviously not everyone breastfeeds, some moms can’t get back to sleep or sleep while breastfeeding, some feel too nervous or uncomfortable when co-sleeping, etc. But for many it’s a great solution – I can’t recommend it too highly. My partner also enjoyed it 🙂 (because, no, it does not mean no sex ever) also, we never had any problems whatsoever relating to bed safety – neither baby ever got squashed, pushed off, burrowed under covers, etc.(from age 10m, we use a side-crib arrangement, with an open-sided baby bed pushed against ours)

    “If your baby depends on you as a sleep association, she will not stay asleep if you leave the room. You’ve got to camp out all night.”

    That is completely untrue. I have nursed both my children to sleep. For example, my 11-mo falls asleep “on the boob”, at around 7-8pm, and then usually doesn’t wake up until we’re ready to go to bed around 11-12, if then. If she does wake, I breastfeed for about 5-10 minutes and she goes right back to sleep. Not a big deal. (when she was younger, under 6m, she would wake more often for evening feeds, but later slept the night through.)

    And my 4,5 year old, who was nursed to sleep until she stopped breastfeeding at 2,5, falls asleep with a parent lying or sitting next to her, singing a lullaby, and then sleeps the night through (in her own room, which she transitioned to at 3 without any problems whatsoever). I love this sweet and natural time, and fail to see the point of striving not to be “not being a sleep association”.

    I would like to point out that we are not self-sacrificing AP fanatics, we just go with the solutions that *for us* offer the most comfort and least effort – for both parents and baby. 🙂

    Liked by 2 people


  2. […] getting your baby to sleep through the night is a priority, start with these simple steps. There are no guarantees- but if you’re ready to try, your baby is ready to learn! This […]

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  3. blablabirdie Says:

    I’m thankful my own ped gave the advice ‘If your baby is crying and you need to fight the urge to go and pick them up – you should be picking them up and not fighting the urge.’

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  4. A Says:

    A word of warning to nursing mothers following this advice, but if you work outside the home and want to continue breastfeeding this advice might not be ideal. I know for me, I went back full time when my son was just shy of 3 months. At 4 months my supply dipped quite a bit (which apparently is quite common at that age) becuase pumping just wasn’t the same as feeding on demand. Without night nursing on demand, I can guarantee that we would have had to quit breastfeeding due to supply issues.

    If you are home full time with your baby, the advise seems reasonable. Although I personally would not be comfortable with the amount of crying it would take for some babies to take to this routine.

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  5. MCHWonk Says:

    AAP recommends sleeping with baby in the same room as his/her parent(s) until at least 6 months. “The risk of SIDS has been
    shown to be reduced when the infant sleeps in
    the same room as the mother.” AAP Policy Statement 2005

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  6. Dr. Roy Says:

    Here’s the complete AAP policy statement that MCHWonk quoted above: http://aappolicy.aappublications.org/cgi/content/full/pediatrics;116/5/1245. It’s long and well-referenced, and includes 11 specific recommendations concerning SIDS.

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  7. Dora Says:

    Letting your baby cry it out is in fact cruel. The reason why a baby ends up falling asleep after crying is because they have given up on the fact that mommy/daddy will comfort them. I never want my children to give up on me. That is NOT what parenting is all about. No one ever said being a parent will be easy. It takes a lot of work just like everything else in life. Put yourself in your babies shoes. Would you be ok with laying in your bed crying and your loved one not coming in to sooth you? Chances are you would want someone to comfort you. There is one trick I have learned and appears to be working. I start off the bedtime routine the same, bath, book, music, bottle and rocking until fast asleep. When my son woke up, I went in, picked him up and sat in my glider. What I did different and actually noticed a difference was I did NOT rock him back to sleep. I held him in my arms, waited for him to fall asleep and then put him back in the crib. He did not wake up after that until the next morning. Now my son is 12 months old and used to wake up 3-4x’s a time like clock work. He has only slept thru the night a total of 3x’s since he was born. I really think the not rocking is going to get him to sleep thru the night. I truly believe he was waking up constantly because he loved being in mommy’s arms and the rocking motion. Wouldn’t love that. By holding him, it continued to give him the warm comforting feeling and by not rocking him, he is learning that f he decides to wake up just to be rocked it’s not gonna happen. My method was stress free on my little man and allowed him to continue to experience a positive bedtime while feeling secure all at the same time.

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  8. maria Says:

    heres a couple of answers to add to the above. Baby does need reassurance…..and yes you should call every 5 minutes…..and then to ten….my child sleeps12 hours after he gets up in the morning. routine is essential. is he waking at the same time every day, going to sleep same time…is there a ritual at night including a small meal, teeth brushed, washed and jammies on. is changes in the light in the room or the bed they sleep in.. get into a pattern of the same every night. Is the room at the right temepature. is there nappy ok, are they uncomfortable, is the room to bright? Are they getting to many sweets or fizzy drinks late afternoon. is the child getting enough excercise. a morning jog, enough light during the day and enough calories and especially calcium from milk during the day…. take them off the bottle going to bed. make something new like neww bed or duvet cover…. and new rules. they will try to push thoe rules but reasure them and speak in a firm voice….dont shout though. they need to be calm. giving them lots of love during the day, through one to one time, a cuddle, tickling them a little , talking about how much you love them, holding your cheek to theres, willl give them confidence and make them more at peace at night. stroking their hair while drinking their glass of milk before bed. if they can sleep without you beside them, then they willl not need you or a bottle to get bacvk to sleep. you may need to do it in stages. lying their head on a pillow. but have their feet on your lap for one week . move over so your not touching their feet, week two, week three sit on the ground but leaningn on the object they are lying on. then move over a little so your not touching object, and over a little more, then onto a chair nearby, then across the rooom. you must do this with confidence or they will see weakness. sing a song or be boring , “everyone is sleeping; conor is sleeping, june is sleeping, grace is sleeping, margaret is sleeping,” ,get out of the habit of prams and cars to get them sleeping. they will need them if they wake up to sleep again. Are they sleeping too long during the day. 6 or 7 hour later after they wake from a nap, my babies would sleep for the night.
    Now finally here is the answer for my two babies…. stop giving them the bottle at night. offer them water. speak to them reasuring them. tell them you cant find it. its lost. … give them a small amount of grapes or small yogurt if they are unconsoable. place your hand on the crown of their head, and repeat the words, “I Know I know I know. its awful, we cant find your bottle….!” be with them in their sadnesss. show them you understand and tell them youo willl tell everyone granda , grannny, name everyone, to take there mind off it. then tell everyone the next day. and the next day, how brilliant they are. they will start eating more the next day ,get plenty of milk into them the next day. Reverse psycholgy works tooo. tell them they aren’t going to sleep. when you see they are tired but figity, lift them up onto there feet and give them a hug, they shoulld try to lie down again. if you feeel theyre not tired sing them songs to calm them. water might get rid of sugars. good luck!

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  9. Alain Latour Says:

    Thanks for the post — and for the blog, which I consider excellent.

    Question: you say “by two months of age, you should sometimes be putting your baby down when awake.”

    But what should we do if they do not stop crying? Moreover, won’t I confuse them by NOT doing the same thing tomorrow night, since you say we should this “sometimes”? Should I come back and check on them every 5 minutes the first time, only to extend that a bit the next, a la Ferber?

    I hope this makes sense. Thanks1

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  10. Dr. Roy Says:

    Alain, Dr. Ferber suggests a “gradual extinction”– as you say, checking in at set time intervals, but extending the time every night (or every few nights). That does work, and you can start at that at 2 months or earlier.

    My point though was that many families get into a “rut” of always rocking or holding their baby at sleeptime, and then trying to put them down to tiptoe away. Many parents never even try to put babies down awake. That’s the mistake I’d like parents to avoid, by suggesting that by 2 months, you try at least *sometimes*. It won’t always work, but if you never try, it will never work.

    Best of luck!

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  11. Alain Latour Says:

    Thanks, Dr. Roy. (BTW, I subscribed to this thread but wasn’t notified you’d replied to it. Maybe a glitch worth looking into.)

    I’ve been reading both Weissbluh and Ferber but neither seems to recommend sleep training on a 2- or even a 3-month-old. I guess I’ll give your suggestion. On a different topic, I’m buying your book today 🙂

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  12. Alain Latour Says:

    Meant to say, I’ll give your suggestion a try.

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  13. Ben Leitschuh Says:

    Dr. Benaroch,

    Our 6 month old has struggled with GERD since birth and spits up large quantities often throughout the day and night. She is fed breastmilk via a bottle and has recently started some solids as well. Our pediatrician had her on Zantac and later Prevacid both with very minimal results. She no longer takes any medication. The spitting doesn’t seem to be as bothersome any more in regards to pain, but occasionally still bugs her. Our problem is now deciding which sleep solution to try with her. She has a set routine every night and falls asleep drowsy or awake with no problem. The problem is that she continues to wake 4 or more times per night. We currently feed her or comfort her when the crying doesn’t stop within a few minutes. I should mention that she sleeps in her own crib, but in our bedroom. We are interested in trying the “cry it out” method, but are concerned that the real reason for the wakings may be discomfort due to reflux. Its clear that she has spit up during her sleep in about half of her wakings. Do you have any advice on how to handle this? My wife and I are not getting the sleep we need and haven’t since her birth. We are desperate for help!

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  14. Shazzy Says:

    My little man, was put down every time we realised he was asleep, he was fed well and in a routine, but woke up to 3 times a night for milk until 2.5 years old (tried the cry it out , tough love) on many occaisions and he never changed, would cry for hours for his milk looking back laughing, now at 3.5 nearly 4 years old, he goes to bed on his own, – sometimes will say goodnight im off to bed im tired before ‘bedtime’ and sleeps all night most nights! (so when we thought it wasnt working, always putting him in his cot to sleep etc was the right thing- but not at the time if you understand). We have a bed time routine and he is fantastic! But our daughter now nearly 2 is going down the exact same sleep road – funnily enough they have competely different personalities!

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  15. Kiki Says:

    Horrible advice! I would never go against my motherly instinct and allow my baby to cry herself to sleep! If you have to fight the urge to go to your baby when they’re distressed then it means its wrong. If it feels wrong then it probably is!

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  16. Johan Says:

    Thanks for the info! It’s a battle to get baby to sleep!

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  17. Bradley McNulty Says:

    Awful, unscientific, damaging advice.

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  18. Martha Perkins Says:

    There is no way in hell I’d let my 3-month-old cry himself to sleep. I give him a bottle, let him play for a while, then when he gets drowsy, I grab his favorite blanket and pacifier, move to his room to the rocking and rock him till he’s fast asleep. Since he was cuddled on his stomach with me, I lay his blanket down under him and lay him on his stomach, just like when I rocked him (yes I know SIDS is a risk but he sleeps better that way. Sue me). This all happens around 8:30pm. At 1:30 or so he wakes up and needs to be changed. I do silently, then give him his paci while still awake but sleepy. I then go back to bed. I let him fuss for a bit, but as soon as he starts crying I go pick him up and rock him some more. Sometimes when he fussed he finds his paci and falls asleep on his own. He slept till 8am this morning, when I woke him up. I will NOT be sleep-training him, but let him find his own routine to sleep through the night. And, as you can see, he’s doing just fine on his own

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  19. Stephanie Says:

    HELP ME!!!! I have a 10 month yr old that wakes up every 2 hrs for a bottle ugh its so anoying help me i nneed my sleep again

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  20. Dr. Roy Says:

    Strong opinions abound! If what you’re doing works for you, great. I don’t know why you’d even read this post if you’re happy with what you are doing, but thanks for participating.

    Stephanie, a great, short book for parents wishing to improve their family’s sleep is http://www.amazon.com/My-Child-Wont-Sleep-Sleep-Deprived/dp/1499340923/. Written by a board-certified pediatric sleep doc, it gives parents several options for each scenario.

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