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Getting to Sleep


Once an infant is 4 or 5 months old, what should you do if he cries when you leave the room? What's good and bad about letting him cry it out?

William Sears, M.D.: The "let your baby cry it out" approach comes from an old fear of spoiling kids. But that's a myth; when an infant cries, he's communicating a need, not being manipulative.

Martha Heineman Pieper, Ph.D.: You shouldn't leave your baby to cry, because it's harmful. Even if it gets him to go to sleep without crying, it's only because he's accepted the fact that although he's unhappy, you're not coming. He learns to fall asleep in hopelessness.

Richard Ferber, M.D.: There will always be situations where you have to let a child cry. If you take matches away from a child, he's going to cry. Does this mean he's learning not to use matches out of hopelessness? You're not removing love or care when you help your 5- or 6-month-old baby switch sleeping patterns. The goal is to give him the opportunity to learn to fall asleep in a new way.

For parents who decide to take the "cry it out" approach, one of the most popular methods is delayed-response, or the "Ferber Method." How should they start this?

Dr. Ferber: Well, I don't consider anything to be the "Ferber Method." But once a baby is 5 months old, my approach is to stay out of the room when she cries for the length of time you're comfortable with  -- anywhere from one to five minutes. Then go back in and soothe your baby without picking her up; leave again and stay out for a few minutes. For example: The first night stay out one minute, then three, then five, and continue to go in every five minutes if she is still crying. The next night try staying out for three minutes, then five, then seven, then seven again, until she stops crying. Some parents go in every two minutes night after night, and that doesn't really help.

If it takes longer than three days for the baby to stop crying, then something is wrong; for instance, it could be too much napping or a change in nighttime feeding patterns.

What are some alternatives to this method?

Claire Lerner: The approach I've developed is to put your baby down the first night when she's almost asleep and then leave the room; if she's still crying, come back in a few minutes. The next night put her down when she's a little more lucid and leave the room a bit longer. Stay away for a slightly longer time each night until the baby learns to fall asleep when you leave.

Jodi Mindell, Ph.D.: I don't think it makes any difference if you go in and check on your baby after 30 seconds, 5 minutes, or 30 minutes. To get him to sleep on his own, you just have to leave. If after 20 minutes he's still crying and you can't stand it, you can take him out and then start the whole process again the next night.

What should parents do if their baby has no trouble falling asleep but wakes up too early in the morning and cries for them to come?

Mindell: Try putting her to bed earlier. It's counterintuitive, but it works because sleep-deprived babies wake up more often. She may also be waking up because she's used to being fed. In this case cut down the early-morning feeding by one ounce (if you're bottle-feeding) or one minute (if you're breastfeeding) a day until you've completely eliminated it.

Dr. Ferber: When a baby awakens at a reasonable hour, you should go to him when he cries. But if he's waking up very early and seems to need more sleep, going to him can then become a habit. If that occurs, delay getting him for a few minutes. The next morning go to him a few minutes later. But be prepared  -- there's bound to be some crying.