Approaches to Sleep: Deciding Whether or Not to Sleep Train

Nora Hedgecock, OTR/L - February 19, 2021

Let’s dive into a hot topic - sleep training. With a newborn in the house, the prospect of getting more sleep at night is an exciting one, but what’s the best way to do it? This debate has strong opinions on both sides - with some people championing sleep training as the only answer and others warning that sleep training negatively affects infant mental health and the parent-baby bond.

We encourage you to question any person or source claiming that their path to helping you and your baby sleep is the only way. Just as there is no one right way to parent, there is no one magic method to help every baby get more sleep. Like so many parenting decisions, deciding whether or not to sleep train is personal, and will depend on what you feel is right for you and your baby. All babies are different. You know your baby the best and you are the best parent for your baby.

What the research says…

“Sleep training” ≠ “cry it out”

The “cry-it-out” approach, or the Ferber Method, is often what people first think of when they hear the phrase “sleep training”. However, these days (and in today’s research), “sleep training” refers to a range of strategies from no-tears methods where parents comfort baby as soon as they cry after waking, fading methods (aka “camping out”) where parents gradually move farther away from the crib each night, and modern cry-it-out methods where parents let baby cry for specific, short intervals of time before going in to comfort them. For more information about specific approaches, we love BabyCenter’s articles on no tears methods, fading methods, and cry-it-out methods

We also like the overview of sleep training methods in this article from Child Mind Institute and this one from Parenting Science. 

Does sleep training allow parents and babies to get more sleep?

The body of research on sleep training is still emerging, and can be muddled as studies often look at a mix of approaches and rely on parent reports. However, several studies have shown that gentler sleep training methods, such as "camping out" or "bedtime fading" can improve babies’ sleep and support parent mental health during infancy. 

However, the current research also suggests that improvements following sleep training often fade after a few months. In other words, sleep training is often not a “one and done” miracle fix (unfortunately!). There are so many factors that impact babies’ sleep, and sleep times and night wakings will wax and wane with development. Parents who choose to sleep train will likely need to revisit the strategies that worked for their baby more than once to “re-train”. 

Does sleep training negatively affect infant mental health and the parent-baby bond?

One study that compared two sleep training approaches (graduated cry-it-out and bedtime fading) with a parent education control group, found that the babies in the sleep training groups fell asleep faster and their parents reported fewer night wakings. However, in monitoring the babies’ nighttime activity levels, researchers found no significant differences in the total sleep time between the three groups. They reported that this finding suggested that babies in the sleep training groups were waking up just as often throughout the night, but had learned to stop signaling (crying) for their parents.  

This study, and others like it that have shown babies who are sleep trained still wake up throughout the night but have learned not to cry for their parents, are sometimes used to make the case that sleep training negatively impacts the infant mental health and attachment. 

However, this study found no differences between the sleep training and control groups in parent-infant attachment or children’s emotions and behaviors 12 months after intervention. Zooming out to look at the larger body of research, there is currently no evidence that sleep training negatively impacts the parent-child bond or a child’s emotional well-being. One randomized control trial that compared parents taught a gentle sleep training method with those given regular pediatric care, followed up with families five years later to look at childrens’ sleep habits, emotional well-being, and parent-child attachment. Researchers found no differences between the groups. In other words, sleep training methods had no long-term effects - positive or negative.   

All in all…

The research shows that various sleep training approaches may help babies and parents get more sleep in the short-term, but that there are no long-term effects on sleep habits, infant/child mental health, or the parent-baby bond - positive or negative. Knowing this, there is no pressure to sleep train or not. 

As is the case with almost all parenting decisions, there is no “right” answer. We encourage you to trust your intuition and choose an approach to sleep that feels right for you, your baby, and your family.  

If you decide to try sleep training, It’s important to remember that babies are not developmentally ready to respond to sleep training strategies until 4-6 months of age. Every baby is different and some babies may need longer before they are ready for sleep training. For more information about newborn sleep, check out our blog here

As always, we are here for you. Join us for our office hours where you can ask about all things baby, sleep and beyond - no question is off limits!