Thoughts on Methods for Putting a Baby to Sleep

Please note that this text is intended for parents of baby and not for parents of newborn under 3 months.

What is a sleep-inducing method?

In research and practice, sleep-inducing methods are divided into three broad categories. The categories are not designed to distinguish practices that work better or worse; they simply serve to organize methods according to schools of thought in psychology.

At home, these categories have little influence on our parental choices, which means that our parental approach is often a mix of a little bit of everything, depending on the needs of the child and the family (and that’s fine) and what our heart tells us.

Here is some theory and data from research to sharpen our critical thinking about the various techniques: The broad categories of sleep-inducing methods:

Behavioural methods:

They advocate reducing the emotional and physical involvement of the parent and using gradual delays in responding to falling asleep or during nighttime awakening. The goal is to give the child the opportunity to self-soothe in order to learn to fall asleep on their own.

There are several variations and adaptation possibilities such as standard extinction techniques including the 5-10-15 technique, extinction with parental presence such as the chair technique and gradual extinction.

Here are a set of methods you can use safely: 

The Fading Sleep Coaching Method (FIO)

The Fading Method is a very gentle, no-tears/no-cry (or very little cry) method of sleep coaching where you “fade it out” (FIO). With the Fading method, you continue to help your baby fall asleep (by rocking or feeding to sleep, for instance). But, over time, you gradually do less and less of the ‘work’ to put your baby to sleep. Your baby does more and more on her own. Eventually, your baby is falling asleep independently.

For instance, if you normally rock your baby completely to sleep, you may shorten the amount of time you rock each night until you are rocking for only a few minutes only as a part of the bedtime routine. This method requires quite a bit of patience on the parent’s part, in some cases, but it’s great for families who want to minimize crying as much as possible.

Q: What age for The Fading Method?

Our recommendation is any age over 6-8 weeks old. Since it’s a gentle method, you can try it with any age baby or toddler. And, you can go as fast or slow as you want for younger babies. That said, a mobile baby might be more difficult to keep still. However, it never hurts to try!

The Pick-Up-Put-Down Sleep Training Method (PUPD)

The Pick-Up-Put-Down Method is another gentle sleep training method. The PUPD method works just the way it sounds. When it’s time to sleep, and your baby is fussing or crying in the crib or bassinet, you pick them up and comfort them until they are calm and drowsy.

Then, you put them back in their crib to sleep, repeating this cycle until your baby is finally asleep. Pick-Up-Put-Down is another method that requires quite a bit of patience, depending on your baby. And, unfortunately, it won’t work for every baby. Some babies find being picked up and put down over-stimulating, and they gradually become frustrated and worked up, instead of relaxed.

Q: What age for The Pick-Up/Put-Down Method?

Our recommendation is any baby over 6-8 weeks old. Since it’s a gentle method, you can try it with any age baby or toddler. That said, a baby who is getting heavy can hurt your back to pick them up over and over, of course! For some temperaments, this method makes them angry, though, and is more irritating and frustrating than comforting.

The Extinction Sleep Training Method (aka ‘Cry It Out’ or CIO)

The Cry-It-Out Sleep Training Method, also known as Extinction, usually involves quite a bit of crying on your baby’s part for the first couple of nights. Some parents share that it tends to be less crying, overall, since you are ‘done’ faster (for many, but not all, people).

The way Cry It Out works is simple – you do your bedtime routine, put your baby to bed awake, and then leave the room without returning for checks. If your baby cries, you are not supposed to go in to check on her. Instead, you let her ‘cry it out’ on her own. The thinking here is that if you allow your baby to cry for a period of time, but then go in and ‘rescue’ her, you have all but guaranteed that she will cry for that amount of time the next night because she will expect you to come and “rescue” her again.

Cognitive behavioural methods:

They suggest methods that intervene in the parent-child relationship. For example, these methods work on the parents' expectations, beliefs and perceptions regarding sleep and when the child is older, components are added, such as relaxation techniques, modification of the child's anxious thoughts, positive imagery techniques and others.

Here are some example of cognitive behavioural methods: 

The Chair Sleep Coaching Method

The Chair Method involves more tears than the previous two. However, you don’t leave your baby unattended in the room at all.

First, start by doing your bedtime routine and turn on the white noise. Then, put a chair very near the crib, bassinet, or bed. You will sit on the chair as your baby falls asleep.

The goal is not to help your child fall asleep, nor to help her calm down necessarily, depending on how you implement it. You are generally not supposed to give your child any attention. The reason you are in the chair is only to reassure them that you are there and have not left them alone. Each night you gradually move the chair further away from them until you are right outside the door until eventually, you no longer need the chair at all.

As you might suspect, this method can be very difficult, depending on temperament, and can take many days or weeks. It can be difficult to avoid engaging with your child and “watching them cry” is very difficult. Furthermore, it can be a little confusing to the child (particularly younger ones) when you don’t interact. However, with time and consistency, this can be a good option for parents who do not want to leave their child alone to cry but who haven’t had success with other methods, either.

There are variations to this method (such as Kim West’s Sleep Lady Shuffle) where you do tend to the baby periodically, verbally and/or physically, and then go back to your chair. As with many things, finding what works best for you and your child is key.

Q: What age for The Chair Method?

Our recommendation is over 3-6 months old, depending on how severe the sleep disruptions have been. Since it’s a gentler method, you can try it with just about any age baby or toddler. Of course, if your toddler is already in a bed of which he can get out, this might not be the easiest method to use.

Controlled Crying Sleep Training Method aka Check-And-Console aka The Ferber Method/Ferberizing aka Graduated Extinction

Controlled Crying, or Ferberizing, is considered a ‘crying’ method of sleep training. This technique includes allowing your baby to cry while checking on them periodically using set intervals.

The goal with The Ferber Method is to reassure your baby that you are nearby and to reassure yourself that they are okay. When you go to check on your baby, you are not “supposed” to pick them up nor engage them much, but simply reassure them using your voice and a loving pat for 2-3 minutes, on average.

With Controlled Crying Sleep Training Methods, the goal is NOT to help your baby fall asleep. That is what they are learning to do on their own! Instead, the idea is that they falls asleep on their own, in the same “environment” in which they will awaken periodically throughout the night. The knowledge of how to fall asleep on their own at bedtime will pave the way for them to go BACK to sleep throughout the night. Over time, you gradually increase the amount of time between your ‘checks’.

Q: What age for Controlled Crying or The Ferber Method?

Our recommendation is over 4-6 months old and up to approximately 18 months old, depending on the situation, but encourage most families to try a gentler method first. Older toddlers and preschoolers, we recommend one of our unique methods, especially used for toddlers.

Methods integrating the notions of attachment:

They are the ones who introduce a so-called "transitional" object, such as a comforter. A safe object is chosen by the parent when the child is young and is presented, used, cuddled, etc. routinely when falling asleep, day and night.

Gradually, the child will emotionally invest in the comforter, he will become more and more attached to it, which will allow part of the parental comfort to be transferred to the comforter.

This attachment to the comforter helps to make the transition to self-soothing, a favourable condition for falling asleep on one's own.

Why use a method (and does it work?)?

Sleep methods are a parental choice first and foremost. There are different reasons that can lead a parent to want to adopt a sleep method. Having realistic expectations about falling asleep and sleeping autonomy (falling asleep without being accompanied) is very important, because you can't "make someone sleep" and magic tricks don't exist.

Studies conclude that using one method or another modestly improves the quality and duration of sleep of the child and the mother (fathers have not yet been studied much). The "modestly" here means that for some families it works better than for others, so on average we see effects... that are not magical.

And this regardless of the method. It is good to remember that sleep develops over time (maturation of the brain), but that sometimes, as in the plane, the least risky thing to do and for the good of all, is to put on your oxygen mask first.

Sleep-on-sleep methods are one way among many to act to try to create favourable conditions so that the sleep of the whole family is restorative and sufficient.

Each child is different, each family is different. The fact remains that the need to sleep is vital for children as well as for parents.

Is it the right time? When is it appropriate?

After 6 months, there is no specific age to start or change sleep methods, because each child has their own rhythm. However, there are some guidelines surrounding behavioural sleep methods (especially those with extinction).

Generally speaking, this type of method is not recommended:

• If the baby is less than 6 months old because the brain is not mature enough to soothe itself
• If your baby still needs to feed during the night.
• If the child has a low weight on their growth curve or their development requires special attention.
• If the child has a physical condition that disrupts the sleep maturation rhythm.
• If the child experiences anxiety and stress or needs closeness or other emotional needs to be met during the night. For example, it may be wise to favour other methods when the attachment bond with the parents is more anxious, either because of the separation anxiety phase around 8 months or because the child has an anxious temperament or experiences separation anxiety (even after 3 years old), for example.

Is this the right time for the child?

• Does my child need to drink at night? Is my child following his growth curve? It is indeed important to respect the child's physiological needs.
• Does my child have a cold?
• Do the two parents agree that their child is ready to be guided in learning to sleep independently? (preferably before the child is put in a big bed to facilitate this transition).
• Does the baby experience separation anxiety?

Is this the right time for us as parents?

• Are we in good shape and not too stressed to gently and patiently accompany the resistances and other challenges related to falling asleep (crying, for example)? For example, it may be important not to wait until you are too tired or exhausted; it is better to try to act before you feel exhausted.
• Is this a good time to absorb the possible parental sleep debt during learning? Since there is an average transition of 3 to 5 days, choosing a time that is conducive to parents is also important.
• If learning seems to take more than a week or so, it is best to question the ideal time.
• Do we agree, are both parents comfortable with the steps to follow? Are we ready to support each other during the learning period?
• Do we have a game plan? Questions to ask yourself with a clear head, as much as possible, because two heads are better than one.

Remember that learning to sleep is like learning to walk.

The brain will eventually get there (thanks to maturation) and the only things that parents control are the conditions that surround the development of this learning.

Parents can and must adapt, with confidence and in agreement, the methods of falling asleep to the needs of their children, but also to their sleep needs.

Parents can draw inspiration from one or the other or all of these categories of methods to put the favourable conditions in place when they judge that it is the ideal time for their child to learn to fall asleep on their own.

When both parents live together, it is important to remember that when it comes time to go to bed, it is important to "knit together". For it to work, one thing is certain: you must avoid "one knitting on one side and the other on the other".

The important thing is to have ONE clear message to give to the child. Indeed, parental conflict does not help the sleep of the little ones (nor that of the parents).

You have to be in agreement and comfortable with what you choose to trust each other.

 

Please, you can help us too: 

If you would like to encourage us to continue publishing baby's articles, please visit our site Jem-wellness.com, whose niche is health and well-being. Many of our products are intended to be used to combat illness or disability.

References:

Note: Hyperlinks to other sites are not updated continuously. It is therefore possible that a link may become untraceable. In such a case, use the search tools to find the desired information.

Bastille-Denis, Emmanuelle (2019) Gestion des pleurs au dodo: que faire? From the website of the Centre of treatment of non -sleep. Published September 10, 2019.

Dubois-Comtois, K., Pennestri, M. H., Bernier, A., Cyr, C., & Godbout, R. (2019). Family environment and preschoolers’ sleep: the complementary role of both parents. Sleep medicine, 58, 114–122.

Literature review on different methods Gradisar, M., Jackson, K., Spurrier, N. J., Gibson, J., Whitham, J., Williams, A. S., Dolby, R., & Kennaway, D. J. (2016). Behavioral Interventions for Infant Sleep Problems: A Randomized Controlled Trial. Pediatrics, 137(6), e20151486.

Pennestri, M-H, Ibrir, K, Kenny, S, Petit, D (2022) Your Baby's Sleep text written by several specialists as part of the Sleep Campaign "Sleep on It".

Reuter, A., Silfverdal, S. A., Lindblom, K., & Hjern, A. (2020). A systematic review of prevention and treatment of infant behavioural sleep problems. Acta paediatrics (Oslo, Norway: 1992), 109(9), 1717–1732.

Touchette, E Babies don't sleep through the night at the same age... and other realities about toddler sleep. The Conversation, published July 13, 2021. Popularized article presenting the different methods among others.