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How a pediatrician advises parents on sleep training their children

Michael Gonzalez, MD
Conditions and Diseases
June 15, 2011
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At some point, the novelty of a new baby wears off.

Waking up at two in the morning loses some of its appeal.  Parents often tell me that their baby does not sleep well.  I tell them how they can get their child to sleep through the night in just three nights.  I explain that learning to sleep is a training process, either the parents train the infant, or the infant trains the parents.  Most parents are uncomfortable with my advice, but when they finally try it, they say it works.

Here is how it works:

  1. I do not recommend doing this until your infant is over ten pounds and over two months old.  Once your baby reaches these milestones, you are set to implement Operation Peaceful Night.
  2. I also do not recommend doing this while your child is sick.  It will just create one other variable that will make you worry, so if she has a cold, wait a week or two until she is better.
  3. Put down all the touchy-feely books about getting your baby to sleep.  All the psychobabble in the world is not going to make your infant sleep.  Your self-esteem is going to be just fine without them, I promise.  If they are not too worn, re-gift them at your next baby shower.
  4. Recognize if you have Wimpy Parent Syndrome.  WPS and Operation Peaceful Night are not compatible with one another.
  5. Remove the infant from your room.  Parents and infants that sleep together do not sleep well.  Move the bassinet or crib to the infant’s room.
  6. Feed your baby.  Change her diaper.  You want her to be sleepy, but not asleep when you place her in her crib.  Once she has been put down, leave the room.
  7. Close as many doors between your room and the baby’s room.
  8. Turn off the baby monitor.
  9. Consider buying ear plugs.
  10. Do not go back into the infant’s room until six or eight hours have passed.

That was easy, no?

OK, I will admit it seems a little mean.  The poor little baby is going to wake up and cry, and you are not going to run to the rescue, which is going to make her cry louder and harder.  This may go on for hours or even all night, but at some point, she will realize that crying is not going to get the result it once did.  Previously, crying has been rewarded with being picked up and held, being rocked, being sung to, and being fed. Now, crying gets no reward.  At some point, during these three nights, she is going to figure it out and start sleeping through the night.

Some points to consider:

  • Behaviors that are rewarded continue. When the reward is removed, those behaviors extinguish. The rewards for crying in the middle of the night have previously been a full stomach, a warm parent’s body, and a lullaby. Remove the reward and the behavior will stop.
  • “Isn’t it dangerous to let her cry that long?”  No.  In the history of human existence, no baby has ever cried to death.  It just does not happen.  (This is, of course, assuming your infant does not have any underlying health condition.  If so, speak with your pediatrician before initiating Operation Peaceful Night.)
  • “What if she is hungry?”  That is why I do not recommend doing this until she is at least two months old and over ten pounds.  At his point, she can certainly go eight hours without feeding.  She may not want to, but she can.
  • Plan ahead before initiating Operation Peaceful Night.  Make sure everyone involved is using the same playbook.  Prepare for a couple of miserable nights before things get better.
  • “What if I can not take it and after two hours of crying, I go in and feed her?”  Think about what you just taught her:  If I cry for two hours I get what I want.  Guess how long she is going to cry the next night.
  • “Isn’t this going to emotionally scar her?”  No.  You will get plenty of opportunities to mess up your kid over the next 18 years.  Teaching her to sleep is not one.
  • “But I do not mind waking up and feeding her.”  Great.  Continue what you are currently doing.  However, realize that, once again, sleep is training.  If you wait nine months to remove the reward, understand that there have been nine months of training that you will have to overcome.  Also, realize that as she gets older she will be able to do things that make training much harder, such as climbing out of the crib and opening doors.
  • “How long do I let her cry?”  However long it takes.

I must admit, it sounds a lot simpler than it really is.  It is stressful for everyone involved.  I have done this with my two children.  I remember my heart racing and my palms getting sweaty as each of my children went through this “learning process.”  My wife initially resisted the idea and took some convincing.  After a couple of nights, she became a believer.  Our kids have since then been very good sleepers.

Michael Gonzalez is a pediatrician who blogs at The Anxious Parent.

Image credit: Shutterstock.com

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How a pediatrician advises parents on sleep training their children
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