Could sleep training harm your baby? The truth about five popular methods, according to experts

It’s not quite as simple as just accepting the exhaustion though. Studies¹ show that women who experience poor sleep are at a much higher risk of developing depression, with some research indicating a threefold increase in risk for both antenatal and postpartum depression compared to those with good sleep.

With so many parents desperate for a bit of shut eye – and these stark statistics showing parents can’t always just “get through it” unscathed – naturally, the industry is flooded with books and courses about different sleep methods for babies.

Do any of them actually work though? Could there be benefits for both mother and baby? Could any of them help you? And why are they the subject of so much debate?

We took a close look at the five most popular sleep training methods for babies and toddlers, and the studies behind them, to see which methods scientists and psychologists rate, as well as which methods spark controversy, to help you decide if you should give one a go.

Below you’ll find a method for all types of parents (and babies over six months), with information on how effective each is, as well as the results of any studies showing the long-term effects (whether positive or negative).

If the idea of letting your baby cry it out sounds even more unbearable than the lack of sleep, then you might want to consider the Pick Up/ Put Down Method. Or, if you’re not too fussed about sticking to a strict routine, then the Bedtime Fading Method might be for you. Perhaps you’ve tried all sorts of methods already and have no idea what to try next, so need to think about a customised method developed for your specific situation?

Ready to catch some zzzzs? Our guide below will tell you everything you need to know about baby sleep training and help you decide which one, if any, is right for you. Here’s to a good night’s sleep!

The 5 most common sleep training methods

1. The cry-it-out method

The extinction method or cry-it-out method is the most controversial of all the sleep methods and has been the subject of endless debate amongst parents and sleep consultants. The main issue being, is it ever ok to ignore your baby’s cry and just let them “cry it out”?

The exact origins of this method aren’t known, but it is thought that the idea was first mentioned in 1892, when paediatrician Emmett Holt, who became known as the "father of paediatrics" advocated for allowing babies to "cry it out" in his popular parenting manual, The Care and Feeding of Children.

How does the method work?

After your usual bedtime routine put your baby down in their cot to sleep and leave the room. The extinction method suggests that if they start crying you leave them until they fall asleep, while the more recent cry-it-out method acknowledges that it is not recommended to let a baby cry for more than 10 minutes, at which point you should soothe your baby.

How effective is the method?

Evidence does suggest that this method is effective in getting babies to sleep better². However, it is not known whether the method encourages babies to learn to self-soothe or whether they stop crying because they learn no one is coming to console them or because they have exhausted themselves.

Is the method harmful?

The main thing to note with this method is that the NHS does not endorse it and always suggests that you respond to a crying baby.

The method could be harmful if the parent simply walks away from their baby leaving them crying without checking that the baby isn’t unwell, too hot or too cold, wet or dirty or have become stuck in their cot or bedding.

This method is also unlikely to work on babies with colic.

However, it’s also important to note that some studies have been done around the method and found no evidence that it is harmful to their development while a parent was present. One study³ even shows that the method may help babies develop self-control and sleep better in the long run. Some of these studies are fairly dated though and a lot more research needs to be done to be conclusive.

You’ll also want to think about whether the method might cause you harm as the parent – listening to a baby cry and not acting isn’t for the faint-hearted and can cause distress.

2. The Ferber Method

The Ferber Method, also known as graduated extinction or graduated crying-it-out, is a sleep training routine that was created by Richard Ferber, a physician and the director of The Center for Pediatric Sleep Disorders at the Children's Hospital Boston in the USA in his best-selling book Solve Your Child's Sleep Problems which was published in 1985.

In a nutshell, the method uses gradually increasing increments of "controlled crying" time to allow babies to learn to self-soothe without causing distress to either baby or parent.

It's a super simple, yet effective method, that's easy to stick to once you know the timings and doesn't require any brain power from frazzled parents. The method is designed to help babies learn to self-soothe gradually so that they eventually know how to get themselves back to sleep in the middle of the night without relying on external help.

How does the method work?

You simply allow your baby to cry for gradually increasing amounts of time before you go and soothe them, starting with a very manageable three-minute stint. Start the method after your child's usual bedtime routine (bath, book, bed etc.) and ensure you put your baby down in the cot when they are drowsy and tired but not fully asleep. Then leave the room and start up that stopwatch.

If they don't cry, then happy days! If they do, wait for exactly three minutes and then head back into their room to soothe them.

The way you soothe your baby is important too – it can involve patting or stroking them and talking in a soothing voice but shouldn't involve picking them up and cuddling them, turning on the light or feeding them.

After a short time (a minute or two) leave the room again and set the stopwatch for five minutes. This part of the method is called progressive waiting and, while Ferber's time intervals are good guides, it's important to make the wait intervals work for you and your baby

Ferber suggests you continue the method of progressive waiting on day one until you reach a 10-minute wait interval. At this point, each time you leave the room wait another 10 minutes until you're confident baby is asleep and content. If your baby wakes up again in the night start the method again from the first three-minute wait.

On day two the wait times increase ever so slightly to five minutes for the first check, 10 minutes for the second check and 12 minutes for the third. And then on day three it's 10 minutes, 12 minutes and 15 minutes.

The Ferber Method sets out timings for up to a week, but a lot of parents and sleep experts find that by the end of day three progress has usually been made.

How effective is the method?

The good news is that research⁴ and 14 studies involving 748 participants show the method is effective in reducing bedtime problems and/or night wakings, especially if parents are consistent and follow the approach to the letter.

Is the method harmful?

One study⁵ that involved 178 babies concluded that cry-it-out sleep training methods, including The Ferber Method, aren't harmful to babies either physically, behaviourally or emotionally. These children also didn't have any differences in their attachment to their parents at 18 months of age, when compared to babies that hadn't experienced any form of sleep training.

Another study⁶ also showed that babies of parents who had used a sleep training method did sleep longer and without any negative side effects.

However, a different paper⁷ concluded that there's a lack of evidence currently either for or against the method and that future research "should compare the effectiveness of various behavioural sleep training methods as well as their possible harmful effects."

3. The Chair Method

One of the gentlest forms of “sleep training”, The Chair Method, involves sitting in a chair next to your baby’s cot as they fall asleep. Each night, you move the chair further away until you’re out of the room.

Importantly, both verbal and physical reassurance is encouraged to help your baby remain calm and happy. This gradual approach is believed to provide reassurance while encouraging independence.

This method is sometimes known as the Camping Out method or The Sleep Lady Shuffle as it was devised by family therapist, Kim West over 30 years ago.

How does the method work?

Once you’ve completed your baby’s usual nighttime routine, put them down when they are drowsy but not asleep. Pull up a seat near the cot and give your baby verbal reassurance while they try and get to sleep.

Most babies will fuss a bit as they fall asleep, but if they start crying you can give them physical reassurance by patting, stroking them on the back and even picking them up if needs be, as well as singing or soothing them verbally.

Once asleep, leave your chair and the room and get on with your evening, keeping an eye on the baby monitor and listening for crying. If your baby wakes again, repeat the process.

After three nights, move your chair from next to the crib, to halfway across the room and after another three nights, put your chair in the doorway. Finally, put your chair in the hallway but in view of baby and aim to reduce any verbal reassurance. After a couple of weeks, you should be able to walk out the room into the hallway while baby self-soothes.

How effective is it?

If the idea of letting your child cry and not being there to reassure them is too much to bear, then this might be a better technique for your family. The method is gentler than controlled crying and can work well for children who need extra comfort.

However, it may take longer than some other methods, so you’ll need lots of perseverance and an empty social calendar! This method may also only be effective depending on the age and personality of your child. Some babies are distracted by having a parent in the room, and others might see you’re there and just cry and cry to be picked up.

Is the method harmful?

No – this is a gentle sleep training method that prioritises reassuring both baby and parent in the process and isn’t harmful for either.

The only negatives to this method are that the parent may have to spend a large proportion of their evening sitting in a chair in baby’s room rather than cooking and eating a healthy dinner or prioritising their own self-care, which is important when sleep deprived.

4. The Pick Up/ Put Down Method

Another gentle sleep training method, The Pick Up/ Put Down Method, does what it says on the tin. When your baby cries, you pick them up and then put them down again before they fall asleep. Again, the exact origins are unclear, although some attribute it to Tracy Hogg, sleep consultant and author, and her book Secrets of the Baby Whisperer.

The method is a combination of graduated extinction methods like The Chair Method and The Ferber Method and attachment theory methods that encourage parents to always respond to their child.

How does the method work?

To do this method you put your baby down in their cot when they are sleepy but still awake, then leave the room quietly. If they fuss, let it happen for a short while but if they don’t look like they’re settling pick them up and soothe them, then put them down before they fall asleep in your arms.

Keep repeating the process until they fall asleep in the cot.

How effective is it?

This method takes time and effort and might not work for many weeks, but is favoured by parents who don’t want to let their baby cry and prefer a hands-on approach. This method only works with consistency, so parents need to be dedicated and patient.

Some babies may find being constantly picked up and put back down stimulating rather than relaxing.

Is the method harmful?

No, babies are used to being picked up and soothed by parents and research in 2016 proved that babies can’t be spoiled by being cuddled too much and even turn into healthier, less depressed, kinder, more empathetic, and more productive adults.⁸

Many other studies show that cuddling and being held releases oxytocin in both baby and mother and is key for their development.⁹

5. The Bedtime Fading Method

Some parents survive the early years with a strict routine that they don’t deviate from at any point, while others favour a more relaxed “anything goes” vibe, with children leading the way on everything from when to eat to when to nap.

This last sleep training method is definitely one for the latter. This method is best for slightly older babies and toddlers who are consistently resisting going to bed each night and aims to reset their internal clock.

This method was devised by two professors of paediatrics and isn’t a solution for multiple nighttime wakings. Instead, it’s intended to encourage compliance at bedtime and to tach children how to fall asleep.

How does the method work?

Similar to how adults adjust to jet lag and a new time zone, Bedtime Fading involves temporarily moving your child’s bedtime later to when they are naturally and physiologically sleepy, then gradually bringing it back to the earlier time that fits in with your schedule.

This helps build a strong association between bedtime and falling asleep quickly and removes any negative associations with not being able to get to sleep.

It's a “no tears” method as you are simply waiting until your child is tired enough to naturally fall asleep. If you child doesn’t fall asleep within 15 minutes of the new bedtime, you need to push the bedtime back a little bit again the next night.

How effective is it?

Some small studies suggest this method is very effective – an Australian study saw average times for preschoolers to fall to sleep change from 23 minutes to 12 minutes in just two weeks. It also showed that total time spent awake at night decreased from an average of 32 minutes to 24 minutes[10].

Bedtime Fading is especially useful for children who resist bedtime or take a long time to settle. It can help reset your child’s internal clock and improve sleep onset.

This method is particularly useful for when you have a toddler or preschooler who can’t make it through the day without a nap but then doesn’t feel tired enough to sleep at night.

Is the method harmful?

No, this is a gentle method of sleep training and there’s no evidence to suggest it is harmful for either parent or child.

The only thing to consider when using this method is that your child may be tired after having later bedtimes at the start – so you may want to try it when they don’t have to wake up early for nursery or school and have a relaxed schedule during the day.

So, is sleep training harmful for babies?

There’s no one-size-fits-all solution when it comes to sleep training and you may want to borrow elements from the different methods or adjust them to suit you. The key thing to remember is to be consistent. Anecdotal evidence and studies show that these methods only work when parents are patient and put in the effort.

And, while many more studies need to be done, early evidence suggests that sleep training isn’t harmful to babies or toddlers as long as a parent is aware of safe sleep methods and checks why their baby might be crying.

If you’re still in a fog of sleep deprivation and have no idea where to turn next, speak to your health visitor or a qualified sleep consultant for advice. Sweet dreams!

Pics: Getty Images

References:

1. Okun ML, Mancuso RA, Hobel CJ, Schetter CD, Coussons-Read M. Poor sleep quality increases symptoms of depression and anxiety in postpartum women. J Behav Med. 2018 Oct
2. Bilgin A, Wolke D. Parental use of 'cry it out' in infants: no adverse effects on attachment and behavioural development at 18 months. J Child Psychol Psychiatry. 2020 Nov;61(11):1184-1193. doi: 10.1111/jcpp.13223. Epub 2020 Mar 10. PMID: 32155677.
3. Bilgin A, Wolke D. Parental use of 'cry it out' in infants: no adverse effects on attachment and behavioural development at 18 months. J Child Psychol Psychiatry. 2020 Nov;61(11):1184-1193. doi: 10.1111/jcpp.13223. Epub 2020 Mar 10. PMID: 32155677.
4. Behavioral Treatment of Bedtime Problems and Night Wakings in Infants and Young Children, Jodi A. Mindell, PhD1,4; Brett Kuhn, PhD2; Daniel S. Lewin, PhD3; Lisa J. Meltzer, PhD4; Avi Sadeh, DSc5
5. Kahn M, Barnett N, Gradisar M. Implementation of Behavioral Interventions for Infant Sleep Problems in Real-World Settings. J Pediatr. 2023 Apr;255:137-146.e2. doi: 10.1016/j.jpeds.2022.10.038. Epub 2022 Nov 12. PMID: 36375604.
6. Bilgin A, Wolke D. Parental use of 'cry it out' in infants: no adverse effects on attachment and behavioural development at 18 months. J Child Psychol Psychiatry. 2020 Nov;61(11):1184-1193. doi: 10.1111/jcpp.13223. Epub 2020 Mar 10. PMID: 32155677.
7. Smith, Bobbi, "The Ferber Method and Other Behavioral Sleep Training Methods: Do They Disrupt Attachment and Impact Physical and Psychological Wellbeing?" (2016). Nursing Masters. Paper 31.
8. Cooney MR, Short MA, Gradisar An open trial of bedtime fading for sleep disturbances in preschool children: a parent group education approach. Sleep Med. 2018 Jun

Read more:

• 6 sleep consultant-approved techniques to help your baby sleep through the night
• Sleep regression ages: signs, causes, and how to cope
• Best lullaby songs and lyrics to soothe your baby to sleep