Sleep Training Your Child

*Note this blog contains a topic of controversy amongst parents. This is my story and why we chose the sleep method we did. I am not saying that other methods are wrong, just my reasoning for my choice.  YOU have to do what's right for YOUR family.*

Okay so this picture is a little (or a lot) misleading, this blog isn't which is better it is why I use one over the other.  In my family we sleep trained (a.k.a. cry it out method) my daughter.  We did not start out like this.  When we brought her home from the hospital we knew we didn't want to co-sleep, the risk of rolling over on her, or her suffocating on our blankets (she was born in December) was a real fear. BUT, she did sleep in a co-sleeper right next to our bed.  I tirelessly woke up every hour on the hour, brought her in bed snuggled her, fed her, changed her...and the repeat EVERY HOUR. After a month or so this routine got a little old, especially since I was home with her all day and could barely function.  So then we moved her into her own room. She woke up every hour (maybe two if we were lucky) and would not go to sleep unless she was laying on my chest.  Most of the time when she woke up she wasn't wet or hungry, just wanted to be on my chest.  We tried sleep aids like the music bear, or the bear that has a heart beat. I was exhausted, and quite frankly so was she, Isabella napped like crazy during the day, because she wasn't getting any sleep at night.  It was two months in and I was desperate for a solution.  I was going to go back to work in a month and I could not imagine being awake for the majority of the night, just to go to work and work all day with my clients (I was an in-home ABA therapist for children with Autism), so I needed to be alert at work.  I was at my wits-end and didn't know what to do, until a friend of mine suggested the book Baby Wise...and it was a GOD SEND!

When I was reading Baby Wise I started to research the "cry it out method" as well as co-sleeping to see if the hype was true about how bad cry it out is for kids, and to also see what negative impact if any co-sleep had.  What I found through my research is that neither method caused negative emotional or mental impacts on children, even in follow-up studies six years out.  The researchers ran tests analysing: mental health, sleeping patterns, psychosocial functioning, relationship with parents, mother's mental health (depression, anxiety, and stress), parents' parenting styles, and levels of stress. Stress levels in children were determined by measuring cortisol levels in children's saliva.  The results of the study were: "At the five-year follow-up, 225 children and their families were included from the 326 that were eligible (69%). The key finding of this study was that there were no differences seen between children and their mothers who received a behavioural intervention compared with those who received usual care for any of the outcomes studied. This was found for both unadjusted and adjusted data." 

This means that all of the "bad things" that people say crying it out causes, are scientifically proven to not exists.  There was one study that did say that crying it out was detrimental, however when you look at the group of children, they were Russian orphans, who spent their entire lives in the cribs.  They were fed, changed, and slept in the cribs and were never cuddled or interacted with in any way...this is NOT the cry it out method...that is neglect...BIG difference.  Additionally, when I read up on co-sleeping and spoke with parents who chose to co-sleep, I found that a big complaint from almost all of them was that their children co-slept for WAY longer then the parents wanted.  I heard parents say that it was very difficult to transition their kids to their own rooms and often times slept with parents until five or six years old, if not longer.  This often resulted in the parents taking different beds and splitting the kids to make sleeping easier.  Now I know this is not everyone's scenario, but it did come up a lot more often then I would have expected.  So, my husband and i decided to go with the cry it out method and we loved it.

As the picture states, consistency is the key.  Just like my previous posts about functions of behavior and consequences, if you are trying to change a behavior you need to be consistent with the consequences.  So this is how we effectiely (and quickly) sleep trained our daughter with cry it out.

The first thing you need to do is determine a schedule for you and your child.  It doesn't need to be super stroked, but it does need to follow pretty closely every day.  Now when I say schedule I don't mean regiment every aspect of your day, I mean plan out when you will put your child down for naps, when ideally they will eat, and when they will go to sleep.  This will help you outline your day and stay consistent. Next you have to determine how much sleep your child needs (see the chart below).  Once you know how much time your child needs to sleep at night and during the day, you can figure out how long he should be awake before each nap.

I started sleep training when my daughter was two months old, so she was up for about three hours before each nap.  Upon waking up I would take my daughter out of the crib and bring her downstairs.  I then would prepare he breakfast and feed her.  After she finished her milk I would play and interact with her as much as possible, getting in all the cuddles, social interactions, and learning that I could. When we were at the three hour mark I would take her upstairs and put her in the crib and leave.  Here is where the consistency is VERY important.  She would obviously begin to cry (because playing with mommy is WAY more fun then going to bed, duh), but I would wait and see.  If she cried for 10 minutes I would wait for a second of quiet (usually when she was inhaling) and then go in and pick her up. I wouldn't be overly exuberant and active, I would just pick her up and spend a little more time with her, either downstairs or in her room (because obviously she wasn't tired yet).  I was still happy and friendly with her but just not as much engery, because I wanted to signal to her that it was time to relax.  After about five minutes of interaction I would put her back in the crib, and leave. I did this same routine before every nap, and I will tell you she only got to the 10 minute mark of crying twice, all the other times she stopped crying within a few minutes and would lay in bed quietly until she fell asleep, usually five or so minutes later.

I also started learning her cues other than crying.  According to baby wise, crying is a child's last resort at communication, children have dozens of subtle cues that we as parents need to learn and respond to.  For instance, if I heard her make noise in the crib (not cry, but just tussle) and I saw in the video monitor that she was sucking her hands, that was a sign she was hungry, so I would go in and take her out and start the entire routine over.  I learned to pay attention to signs such as rubbing eyes (when she got older), eyes staying closed a little longer during blinks etc, to refine my schedule so that I put her in the crib when she was tired, so that she would spend very little time awake in the crib.

At night, when she would wake and cry, I would look at the time.  If it had been a few hours and she could be hungry I would go in and feed her, if she did not feed I would just put her back in her crib (once I made sure she was dry as well) and leave; if she fed, then once she was done I would change her and put her back to bed. I remained quiet and calm during this time like I did before naps to signal to her that it was in fact time to sleep.  If she was crying and it was to early for her to feed, I would wait to see if she calmed down, if she did great, if she hit the 10 minute mark I would go in to her room, take her out of the crib, try to feed her and change her and then put her back in the crib.  By doing this you are helping your child associate certain stimuli (i.e., her crib, quiet voices, relaxed mannerisms, etc) with sleep, instead of associating your bed, the car seat, or nursing with sleep.

We did formal sleep training for about two weeks, after that she was sleeping almost entirely through the night, waking up only twice to feed.  Any other time that she woke up at night she was quiet, and just observed the night time light toys attached to her crib and fell back asleep.  After the first three days she wouldn't even cry when I put her in her crib for naps or bed, and fell asleep within minutes.  I was rested and happy, and she seemed to be happier as well, and I felt like I was able to interact with her more than before, because she was not spending the majority of her day asleep, trying to recoup from the sleepless night before.

Finally, I don't see any issues with my daughter today that I have heard listed as "horror stories" that happen with cry it out.  She is a happy, loving, cuddly, kind child who is still a great sleeper and goes to bed with ease.  I feel like she has a great connection with both my husband and myself, and her emotional and social interactions are on par to her peers that were not sleep trained.  Like I said, either way that you decide to raise your children, it's up to you.  Scientific evidence shows that there are no negative psychological effects to either method. I chose sleep training because it was what was best for my family, and I will sleep train my son when he is two month old as well.  I wanted to right this post to help clear up some of the misconceptions about sleep training and show that the parents that sleep train are not "uninformed monsters" but parents who made the best choice for their family, and that should be respected, not judged.

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