How to Sleep Train Your Child

I'm often asked about sleep training a child. Let’s first address a few things.

Consider this a disclaimer.

1) Every child and every parent are different. They have different needs and it is best to individualize the support that you need for your child's sleep issues. In this context, I can only give you general ideas and concepts.

2) If you have a specific concern about a physical problem that your child may have, the best resource is your pediatrician, your medical provider, or your pediatric sleep doctor.

For children who are newborn to three-months old, know that they will sleep on their own schedule. They may be sleeping most of the day. They may be sleeping most of the night. And they may be awake for long periods of time or short periods of time. There is no specific training that needs to be performed at that very young age.

Most infants will start sleeping through most of the night at around three months of age and certainly by six months of age. Those who are not sleeping through the night at six months of age need modifying of their schedule.

Parents who are having difficulty with a six month or older infant can get some help in getting a child to sleep through the night. In the first year of life, it's vital for the parents to understand that you're not going to spoil your child or damage them - both ways - by hugging them, holding them, gently rocking them, or giving them comfort when they need it.

Then again, the issue depends on the child and the parent.

Each age range of children has its common difficulties with sleep. A lot of questions are about younger children and infants. So I will address that today.

If your infant between 6 and 12 months of age is not sleeping through the night, ask, "why might that be?"

A common answer is the infant has not yet been weaned feeding during the night. If that is the case, you have to gradually wean off the nighttime feedings because physiologically, an infant over six months of age, does not need to be fed during the night. Their body is perfectly capable of maintaining blood sugar levels through the night.

However, what about weaning infants off feedings if they are a breastfed nursed infant? In this case, do not interfere, because there is a lot of difference between breast milk and formula. Formula-fed infants tend to stay asleep for more extended periods. Their routines are different. Breastfed infants need feedings more often, and they will continue to wake up during the night.

Suppose you are trying to wean an infant from feeding during the night and typically provide one or two formula feedings. In that case, you need to gradually either decrease the amount of formula you put in the bottle for the baby to take or dilute it with a small amount of water, so there is less nutrition that the body is dependent on -- but only during the night.

To clarify, if an infant is being given formula during the day, then do not dilute it. Most infants do not need to be given water during the day and are OK with just the formula.

Another question is, "should I let my child cry?" and "Is there something wrong with letting the child cry for a long time?"

These often lead to questions such as: "Is there something wrong with this?" "Is it hard to do?" "Is it not hard to do?" "Is it a good method to help a child learn to sleep through the night?"

In some cultures, children will sleep in the same bed as their parents for an extended period. In other cultures, they sleep separately in a crib in the same room, sometimes because of a lack of space. In other circumstances, children have a separate room to sleep in, and they sleep in a crib separate from their parents' bedroom.

So then again, it depends. On the situation, the parent and the child, and what you're trying to achieve.

The primary concept to understand is that young, normal, and healthy children will change their habits.

They will adapt to a new habit very quickly.

It is often the parents who feel anxious about letting their child cry at night and can feel it is too hard to do sometimes. I hear from parents that they feel this is emotionally too hard on them or their child, so they feel nervous.

Suppose you have decided that your child is not sleeping through the night, and you're going to let your child cry out for one night, two nights, or three nights until he or she can learn, soothe themselves, and sleep through the night. And you're comfortable with this idea.

There is nothing wrong with that.

For other people, it seems too extreme. And in that case, there are modifications of the same routine to try. Some parents will check on the baby multiple times, walk in the room, walk out of the room, give the baby some water to drink, give them a pacifier, etc. Again, this is a matter of what you are comfortable with and how your child responds to it.

The bottom line remains that given the right circumstances, given that your child is otherwise normal, and given that you are not going to any extreme, your child is going to learn and adapt to whatever you try to teach them very quickly within a few days.

So if you're willing to sweat it out and you think this is not particularly dangerous for your child, you could let them cry for an hour, hour and a half, two hours for the first, second, or third night.

They are going to very quickly learn to sleep through the night.

If you can't take it or think this is too traumatic for your child, check-in with yourself. The real gauge of trauma is how you feel and how you see your child react to the situation.

This is why I say to claim that there is an official, specific rule that applies to all children is wrong.

You have to be conscious of your feelings about the situation and your child's feelings.

You, as a parent, are more reliable in my perspective than anybody else.

Your feeling is more important.

At the same time, as a physician, I want you to be confident in your being a parent.

You are the one who's going to control the situation, not the infant's personality. This tends to be something that happens almost between every child and every parent. There is a power struggle that starts at three or four months of age, and it's never-ending.

So what is the bottom line?

The bottom line is:

1) Be aware of your comfort zone and how your infant or child reacts to the situation.

2) When in doubt, talk to your medical provider.

3) Be consistent. A lack of consistency on the parents' part is a significant contributor to children having sleep problems.

If you need specific help, we're here for you. Call us, email us, text us. We're here to help.