guide – Sleep Training Kids

When we were looking at using the Ferber method for our kids, we wished there was a guide we could quickly refer to when we needed a reference. Here is everything we wish we'd had in a very thorough beginner's guide to Ferberization. Designed by Dr. Richard Ferber, the Ferber method of sleep training uses graduated extinction to teach children to fall asleep without relying on negative sleep associations. At regular, predetermined times, parents can check in on their children and provide verbal comfort. Ready to see everything you need to know about the Ferber method in one place? And to have it explained step-by-step in everyday, easy-to-understand English? Let's do this. What is the Ferber Method of Sleep Training? At its core, the Ferber method is a one-trick method. It is perfect for helping children learn to fall asleep - and to do so without requiring any sleep associations (like parental soothing). Or if those negative sleep associations already exist, the Ferber method can help you and your child break those habits quickly. In other words, the Ferber method helps you and your child learn to go from crazy difficult bedtimes to easy ones. The most common one example includes going from having to rock your baby to sleep (and praying that putting them down doesn't wake them up so that the whole bedtime routine starts over) to just being able to put your child to bed (and saying "good night! Sleep tight. I love you!" or something along those lines). The idea is that if your child can learn to self-soothe at bedtime, then when they wake up during the night they'll have the skills they need to go back to sleep without requiring any (parental) help. That's the ideal - and it does happen in many if not most cases - but not all. But don't worry - this guide will address all of those potential scenarios. The Ferber method works by using graduated extinction, also called "gradual extinction" and "progressive watching". Translation: the Ferber method works because it uses short-term behavior modification - by letting your child cry for a few minutes at a time while still providing parental comfort at the prescribed check-ins. Who Should Use the Ferber Method The Ferber method of sleep training is a fantastic short-term tool for children (over the age of 4-6 months old) who require extensive comforting at bedtime - or who have other negative sleep associations that need to be addressed (in order to improve sleep quality and quantity). If your child and family meet all (or most) of these conditions, then the Ferber method may work well for you. Your baby is at least 4-6 months old (Dr. Ferber says 5 months).There are no underlying medical concerns that impact sleep quality or quantity - including nighttime fears or separation anxiety.There are negative sleep associations making bedtime harder or longer than necessary. Not sure what a sleep association (let alone a negative sleep association) is? Sleep associations are things that help us sleep. Negative sleep associations are things we need to sleep but we can't do by ourselves - so we require help, usually from parents. However, they quickly become problematic, as negative sleep associations cannot be easily replicated and are distracting. As such, negative sleep associations become crutch-like problems that need to be removed. To read more about sleep associations, read our article on it here. In my experience, it's actually easier to see if the Ferber method will work for you by seeing if it won't work for you. So let's look at that. Who Should NOT Use the Ferber Method Is the Ferber method for everyone? Definitely not. In fact, if your child is sleeping poorly for any other reason than negative sleep associations, it probably won't work. The Ferber method is NOT for you if: your baby is under 4-6 months of age;there is a conditioned vomiting response (your baby vomits if they cry too long);any extreme fear of being alone;there is any sleep problem other than negative sleep associations;you have tried it and haven't seen any success by day 7. Common sleep-related problems (other than negative sleep associations) that may disqualify the Ferber method as a viable option include: nighttime fears and separation anxiety;nightmares, sleepwalking, and/or night terrors;circadian rhythm sleep disorders high levels of daytime stress; sleep-disordered breathing like snoring or apnea;underlying medical conditions (addressed or not);sleep schedule problems caused by bedtimes that are too early or too late. This isn't to say that you can't use this method at all if you're concerned about one of these above issues. Families I've talked to have been able to modify the Ferber method to still help see bedtime success - even if they then had to use a different sleep training technique for other issues. When to Ferberize Dr. Ferber officially recommends starting sleep training when your child is between 5-6 months of age. In fact, he says that 5 months old is his ideal age for sleep training. Odds are, though, that as you're reading this your baby isn't exactly 5 months old. If so, that's okay. The Ferber method will generally work for children anywhere from 4-months-old and up. 4 months is often listed as an option because some families have seen success at this age. The Ferber method will only work at this age if your baby's brain has matured into the more adult-like sleep pattern (read more about sleep training guidelines here) - and your baby's nutritional needs are met during daytime hours so that they can sleep all night. So the odds of the Ferber method working at 4 months old are there - but the odds improve greatly at 5 months old and older. The Ferber method can also work well for older children - it's worked well for families of toddlers and preschoolers, too. Some families I've talked to do make minor modifications for older children, though. Yes, we'll talk about common customizations and modifications later on in the article. How to do the Ferber Method of Sleep Training While most people focus first on the set intervals for checking on your child, there are a few, vital steps that tend to get skipped if you start with the check-ins. So let's make sure we start at the very beginning - so that you'll see success with the Ferber method. Step 0 is to get and read Dr. Ferber's book, "Solve Your Child's Sleep Problems" (click here to check format options and pricing on Amazon). That way, you'll have that read and on hand for any specific questions. Then, be sure to bookmark this page so you've got it for a quick reference. Plan to start sleep training over your weekend - or another time when you can afford to lose some sleep. That way, you have time so you can take a nap.Move your child's bedtime to the time when they fall asleep. If bedtime routines used to start at 6:30 but then got dragged out until 7, then move the bedtime later (to 7 PM) and start the Ferber method's progressive waiting at 7.Be prepared to be consistent for all naps, bedtimes, and middle of the night wakings with your Ferber method strategy.Practice keeping your promises - if you say that bedtime is one book, keep that promise. This is learning to set limits and is important to the Ferber method.For older children, consider using a reward system (like stickers) to reinforce success. This should help break poor sleep habits and associations.Use a timer for the progressive waiting.If there is no success after 4 nights in a row, it's time to rethink your approach. Once those steps are done, then (and only then) can you begin to use the Ferber method with your child. So let's go through those steps next - this is the "Progressive Waiting" technique. Go through your usual bedtime routine, focusing on calming down and getting ready for sleep. If baths or stories are not calming for your child, remove them from the bedtime routine.Place your sleepy baby in their crib while they're still awake. Their crib should preferably be in a room where the parents (you) don't sleep.Leave the room. If your baby cries, wait the prescribed amount of time for the first check before coming back into the room and offering comfort.Comforting your baby should be patting them on the back, making a "shhhh" sound, talking to them in a soothing voice, speaking softly, and keeping the bedroom in its sleep-ready state. In other words, keep the lights off and do not pick up your baby or feed them - that all just happened already during the bedtime routine.Keep comforting your baby to 1-2 minutes. Make sure you speak quietly and calmly.After comforting your baby, leave the room.Wait and allow your baby some time to self-soothe. Continue this process, while extending the wait time between checks. Your child should fall asleep without you being in the room.If your child wakes up in the middle of the night, repeat this process to help them go back to sleep. Here's how long to wait between checks, depending on which day of training it is. DayFirst Check After:Second Check After: Third Check After:Subsequent Checks After:13 minutes5 minutes10 minutes10 minutes25 minutes10 minutes12 minutes12 minutes310 minutes12 minutes15 minutes15 minutes412 minutes15 minutes17 minutes17 minutes515 minutes17 minutes20 minutes20 minutes617 minutes20 minutes25 minutes25 minutes720 minutes25 minutes30 minutes30 minutes So if it's your first day of using the Ferber method, your first check will only be 3 minutes after putting your child down to bed. Then you'll let your baby self-soothe (or cry) for 5 minutes and check-in on them again. If it's the fourth day, though, the first check will be after 12 minutes. The second check after 15 minutes and the third after 17 minutes. And so on. Just remember the very important fact from earlier - if there's no improvement by the end of night 4, it's time to at least consider changing sleep training tactics. For our children, we noticed that checking on them caused them increased stress and crying. The short amount of time between checks weren't enough for our kids to calm down before we'd have to go back in. Checks became painful - for everyone. We didn't wait till night 4 to change tactics. Why Gradual Extinction Works (and what science says about its safety) Graduated extinction works by using short-term behavior modification to teach both parents and children to let go of negative sleep associations. This makes it easier to sleep in the long term, provided that the short-term plan is followed. In other words, the Ferber method helps everyone go cold-turkey and quit bad sleep crutches, like having to rock the baby to sleep. Because once the baby is done being rocked, they wake up. Or, if they wake up, they want to be rocked back to sleep. Now, with sleep training, the baby won't have to be rocked - and can learn to fall asleep on their own. And that means the parents can get more sleep, too. So while the Ferber method doesn't actually teach anyone how to sleep, it does open up the way for them to figure it out on their own. Sleep training can make for a few rough days, though. If there is already a significant sleep debt or family stress, however, it will be worth it - provided sleep training can be done safely. To read more about sleep training safety (and how to make it safe) read our article on it here. Now let's talk about what science has to say about graduated extinction (and the Ferber method). A study by Riley Children's Health (at Indiana University) found this: …the babies in the sleep training groups showed slightly lower cortisol levels than the babies who had no sleep training. This suggests that in the bedtime fading group and the graduated extinction group, the babies had less stress and anxiety… and fell asleep more quickly and woke up less frequently in the middle of the night.Riley Children's Health website 12 months later, the researchers re-measured cortisol levels. At that point, there wasn't a noticeable difference between the two groups (no sleep training and those that had sleep trained) on any level - cortisol, emotional and behavioral health, and in the parent-child attachment levels. In other words, graduated extinction and the Ferber method do work - and they can be safely used as valid sleep training methods. In my research, I've come across other articles (like this one here on Children's MD) that seemed to show the opposite. One article referenced looked at babies (ages 4-10 months) who used an unnamed version of "cry it out" in a research center. These babies were reported to have a higher level of cortisol on day 3, while the mom's cortisol levels decreased in accordance with the time their baby spent crying. While the actual study referenced (including the abstract) is behind a paywall, there is an important takeaway we can get just from the articles that did reference this study. Sleeping in a new or strange environment is stressful. These babies were crying it out - possibly without check-ins - at a research center. I'd be stressed out of my mind trying to sleep at a research center, too. In any case, studies are still being done on sleep training. Doctors and scientists will continue to see what the ramifications and long-term effects entail - but it's going to be a long road for several reasons. First, most studies are done on a small scale - and so aren't representative of everyone. Second, everyone reacts slightly differently - and so the data tends to play catch-up rather than be ahead of schedule. Third, research just takes time. That's normal. As of right now, though, the general scientific consensus is that sleep training is beneficial and can be done safely - provided that you follow the recommendations and guidelines to make sure your child's needs are all met and that you use intentional crying as a short-term tool. If you'd like to stay up to date on the research and sleep training in general, make sure you sign up for our free newsletter - and we'll help you stay up to date on all things sleep training. Arguments Against the Ferber Method While the general scientific consensus is that sleep training (and the Ferber Method) can be done safely, the truth is that there are two main arguments against the Ferber method. The first argument against the Ferber method is that more research always needs to be done. Much of the general sleep training research is heavily reliant on self-reporting surveys. In other words, there are a lot of untrackable variables at play - and that it's often impossible to determine if a single variable (like the sleep training method) was the right one to look at. For example, many studies come to the final conclusion that sleep training is, generally, safe and beneficial. But often, these studies don't collect the very basic data - like what sleep training method was used. Many parents in these studies are given basic sleep training information - what usually accounts to basic sleep education and child development. Then, many of these parents turn to outside sources for advice and strategies. Sleep location is often not collected, either. So not only do studies not tell us the exact methods used, but they also don't tell us if there is cosleeping involved. So more research - and more specific research - is needed. However, getting some of that research done has some major ethical and moral implications - because it would involve leaving children alone to cry. As such, we may not ever have all of the specific answers that the scientific community would like - because it would be immoral and unethical to collect that data. The second argument against the Ferber method is that letting a child cry is highly controversial - and with good reason. While we would like to think of ourselves as a highly advanced society, the fact is that we humans are still highly influenced by our evolutionary past. And, in the past, letting a child cry was a sign that something was wrong. It may even have been a sign of neglect, abandonment, or attempting to let nature claim the child, which was a practice in some cultures (infanticide). Letting a child cry was also potentially dangerous to the community - especially if there were predators or enemies around. While the odds of a sabretooth tiger hunting us have dropped, the inborn response of millennia hasn't changed in the last few hundred years. Hearing a child cry is still concerning. Is it any wonder, then, that using intentional crying as a part of sleep training, is controversial? No. It's not. Or at least it shouldn't be surprising, in my opinion. However, all of this does rely on the outdated idea that a crying baby is in distress. Studies and research are showing that crying isn't a reliable indicator of distress - which gets us back to the first point of more research, education, and time to confront our evolutionary biases being necessary. Until then, however, any sleep training method that uses crying will continue to be controversial. Modifying the Ferber Method to Work in More Situations Now, there are two schools of thought when it comes to modifying or customizing the Ferber method. The first is this: that if you don't follow the steps - exactly as outlined - then it's A. not the Ferber method and B. it won't work. In some cases, I can see that being the case. And, in many instances, I believe this can be true. The Ferber method, as it's written and designed, will work for many families. Having and following the Ferber method exactly is a fantastic way to get a baseline. However, I subscribe to the second school of thought, which is this: Once you know all of the steps and try them, it's okay to make small changes as needed. Use a plan, implement, and then evaluate style methodology to guide any changes and customization to help you see success. You see, sleep training is a highly individual and family-based event. So if the exact formula for sleep training doesn't work, that's okay. Try the method exactly at first. Then, you'll develop confidence as you see what's working - and what's not working. Then you'll be able to change what's not working (while continuing to use what is working). This is how you'll see the best and fastest success. Let's go over some modification examples. ModificationExample and/or RationaleShorten Check-in TimesSome children may do better with shorter times between check-ins. If so, stay on the upper half of the check-in chart for a few extra days.Lengthen Check-insSome kids do better with a longer interval between check-ins. Go for it.Use a Virtual Check-inSome children may not do well with an in-person check-in. Try using a video camera or a monitor or even a walkie-talkie.Add an ExplanationTell kids WHY you're doing this. Tell them that you're going out of the room - but that you'll be back in X minutes. In my experience, giving them this information (even if they're still young) makes the whole experience much better for everyone - because they know you're coming back. These are by no means the only ways to modify the Ferber method. But the last one is my favorite customization. In fact, you can add in the big kid sleep training changes I've discussed here to all of Ferberization. By adding in explanations, I've found that the Ferber method is actually very usable with toddlers - only they're less apt to cry (because they know you'll come back). By doing this, it adds in some fading aspects, making an even better way to manage sleep training children. Ferber Method Q&A Now, let’s make sure that you’ve got all of your Ferberizing related questions answered. Here are some of the most commonly-asked questions I’ve asked, researched, or been asked by parents like you. Oh, and if you don’t see your specific question (or answer), just shoot me an email. I’ll try to respond to as many emails as I can – and I’ll get your question added to this post. To find out how to email or contact me, click here. What age is appropriate for the Ferber Method? The Ferber method is designed for children who are at least 4-6 months old, with Dr. Ferber saying 5 months is the ideal age to start sleep training. It can work for children up through the toddler stage. In my experience, Ferberization can work up through the preschool ages, too, as long as you modify things to be age-appropriate. Click here to see how to modify sleep training to be age-appropriate for big kids. Is the Ferber Method cruel or harmful? While more and more specific research is always needed, the Ferber method is generally seen as a safe and effective short-term sleep training tool. Ferberization is a fantastic way to remove negative sleep associations or crutches that make falling asleep harder. The American Academy of Pediatrics has determined that behavioral sleep training techniques (including the Ferber method) have no long-lasting effects of any kind - and can be used with confidence. For more information on this and more, read our article on sleep training safety. Is the Ferber Method the same as an extinction method of sleep training? The Ferber method is considered a "graduated" or gradual extinction method because it does allow your child to cry. However, because it uses timed check-ins, it is not considered a "pure" extinction and is generally seen as a less severe sleep training method. Does the Ferber Method work for toddlers? The Ferber method, as it's designed, can work with many (if not most) toddlers. Some toddlers can be Ferberized with some minor, family-based and age-appropriate customizations. In my experience and opinion, the Ferber method works better with toddlers when you explain what's happening - and why it's happening. The "why" aspect can be kept simple - "so everyone gets better sleep and we can be happy when it's playtime" can be a totally acceptable explanation as to why. What's the best age for using the Ferber Method of sleep training? In his book, "Solving Your Child's Sleep Problems," Dr. Ferber has stated that 5 months old is the ideal age for sleep training. He states that it's also the minimum age he recommends for sleep training, and that sleep training at any age thereafter as possible. Dr. Ferber does caution that sleep training may become more difficult as a child gets older. Pediatricians I've talked to generally recommend that the Ferber method can be used as early as 4-6 months of age, as long as it's been okayed by your pediatrician. What should we do if the Ferber method worked at bedtime, but didn't help my child learn to self-soothe during the night? If Ferberization worked at bedtime but didn't work for nighttime wakings, you have a couple of choices. Keep trying the Ferber method at night and see how it goes.Take a break from nighttime sleep training for a while - and then try again at a future date (even as soon as in a couple of weeks).Try a different sleep training method and see how that goes. No matter which you do, though, it's important to determine why nighttime Ferberization hasn't worked. Surveyed families have often discovered and reported to me that nighttime Ferberization failed because of nighttime feedings. In this scenario, families generally had to do one of two things. Some families decided to allow nighttime feedings and wait to wean at a later age.Some families decided to complete nighttime weaning and increase daytime feedings to compensate. There is not a right or wrong answer - there is just what works for your family and what doesn't. Weaning (even just nighttime weaning) is a highly personal choice that you will have to make. For more information on sleep training and weaning options, read our comprehensive article on it here. References & Citations Adams LA and Rickert VI. 1989. Reducing bedtime tantrums: Comparison between positive bedtime routines and graduated extinction. Pediatrics 84(5): 756-761.Commons ML and Miller PM 1998. 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