Why Won't The Baby Sleep Through the Night?

Ferber vs. Sears Sleep Training Strategies for Infants and Toddlers

Sep 16, 2009 Molly Markey

For many, Dr. Ferber's progressive-waiting method is the gold standard for sleep training, but vocal critics of the Ferber method claim it is detrimental to babies.

To a new parent, the phrase "sleeping like a baby" seems cruelly deceptive. On average, a newborn baby sleeps 16-18 hours every day. However, as Dr. Ari Brown and Denise Fields describe in their well-regarded book Baby 411 [Windsor Peak Press, 2006], "Most newborns will not sleep more than four hours at a stretch".

Why Infants Wake Frequently at Night

At first, babies wake frequently because they need to eat. A newborn's stomach cannot hold enough nourishment for the baby to sleep all night. As a baby approaches her 4-month "birthday", she weighs enough to forgo nighttime feedings. But, for young babies, "sleeping through the night" means "sleeping for a six-hour stretch" (Brown and Fields, 2006).

When Will the Baby Sleep Through the Night?

As a baby grows, her ability to sleep changes. Mature, non-REM sleep appears in babies' sleep patterns at around 6 months of age, according to Dr. Richard Ferber, Director of the Center for Pediatric Sleep Disorders at Children's Hospital Boston. In fact, most six month olds are capable of sleeping for 9, 10, or even 11 hours at night without waking.

Why, then, are frequent night wakings the bane of parents of young children? What can parents do to help their children sleep better?

How to Help the Baby to Sleep at Night?

Dr. Richard Ferber describes ways to teach babies how to sleep all night in his landmark book Solve Your Child's Sleep Problems [Simon and Schuster, 2006, expanded edition]. Dr. Ferber maintains that nighttime wakings are normal. At night, all people rouse occasionally to "check" their surroundings.

If nothing in a sleeper's surroundings has changed, people slide back into sleep without completely waking and are unaware of this partial arousal the next morning.

But, if something has changed, the sleeping person will fully wake up to figure out what has changed and why (Ferber, 2006).

Suppose that while a person was sleeping, someone carried him from his bedroom and placed him on the couch. At his next partial waking, the person would be alarmed to find himself out of bed, and startle fully awake. He would have a hard time falling back asleep. Yet, this is nearly identical to the situation that many infants are in when their parents rock them to sleep and then place them in their crib. Similarly, babies who fall asleep sucking on a pacifier may cry during the night when their pacifier falls out because the baby associates falling asleep with suckling.

According to Dr. Ferber, the key to helping a baby sleep through the night is to ensure that his "sleep associations" do not change during the night. This means that he should learn how to fall asleep on his own, in his own crib, if the baby's parents expect the baby to sleep all night in that crib. Ferber cites scientific data and case studies to support his claims.

How Dr. Ferber's Progressive Waiting Method Works: Ferberizing The Baby

• Complete the baby's "sleep ritual" (a bath, a lullaby, etc.).
• Give the baby her last feeding before bed to ensure that she will not be hungry, and change her diaper.
• Place the baby in her crib while she is relaxed and sleepy, but not actually asleep.
• If the baby cries, return in 1 minute to comfort her. Then, leave the room.
• If the baby cries, return in 3 minutes to comfort her. Leave the room.
• If the baby cries, return in 5 minutes, and then leave the room.
• Return in 10 minutes, comfort her, and then leave.
• Continue to return in 15 minute intervals until baby falls asleep. Don't rock or nurse the baby to sleep and then slip her into her crib.

Dr. Ferber notes that most babies will learn to fall asleep on their own in 3-5 days.

It is critical to understand that Dr. Ferber does not recommend using his method with infants younger than 6 months. Newborns cannot self-soothe, so they are incapable of calming themselves down enough to fall asleep and should not be expected to do so.

Parents should also note that Dr. Ferber recommends discontinuing sleep training and contacting the child's pediatrician for more customized help if there is no improvement in the baby's sleep after 1 week. Dr. Ferber clearly states that "The program of progressive waiting is designed to treat only one specific sleep problem: the situation where [the] child has come to inappropriately associate something [his parents] do, or allow him to do, with the process of falling asleep...within a week [if everything is not much better]...[his parents] should be looking for a reason".

Clearly, the Ferber method does not mean simply letting the baby "cry it out" (CIO).

Criticisms of the Ferber Method

Dr. Bob Sears, co-author of The Baby Sleep Book [Little, Brown and Company 2005], is a vocal critic of Dr. Ferber's progressive-waiting approach. Dr. Sears claims that babies who are trained to sleep using the Ferber method exhibit "shut-down syndrome"; that is, they are withdrawn and show signs of distrusting their parents or caregivers (Sears et al., 2005). Sears also maintains that children who sleep alone at night are more likely to suffer psychological problems. Many of Dr. Sears' patients find that co-sleeping and helping babies back to sleep after every night waking is appropriate for them.

Ferberizing is Effective and Appropriate for Many Babies

However, The Baby Sleep Book lacks scientific data to back up claims that Ferberizing is damaging. Sears provides anecdotal examples from his practice, but no formal scientific data. Therefore, Sears' criticism of the Ferber method is unconvincing.

Dr. Ferber's progressive waiting approach is highly regarded by pediatricians and parents as an effective, scientifically verified sleep training method for infants and toddlers. Although this approach may not be best for every baby, there are no data to suggest that Ferberizing is detrimental for babies when correctly used. Parents can feel confident that Ferber's progressive waiting approach will, in most cases, help their babies fall asleep on their own quickly and easily, and prevent prolonged night wakings.

The copyright of the article Why Won't The Baby Sleep Through the Night? in Infants & Toddlers is owned by Molly Markey. Permission to republish Why Won't The Baby Sleep Through the Night? in print or online must be granted by the author in writing.

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