In his piece for The New York Times, Putting Your Baby to Sleep: Some Advice and Good News", Carroll points out it's normal for babies to wake up through the night, "to be fed, changed and comforted". But there is an age when your baby should start to sleep through. And what happens when they don't?
"As a pediatrician, the first thing I do with parents who are experiencing problems is calm them down," writes Carroll. "Sometimes it feels as if it will never go away, but I try to remind them that few teenagers have this issue…This almost always, eventually, gets better."
There are five different schools of thought on how to get your baby to sleep through the night. Parents get heated over which type they think works. But before you get overwhelmed, Carroll shares some very comforting news.
They all work.
"All of the interventions worked to improve sleep," he writes, and "[m]ore important, none caused any concerning levels of stress."
So, take your pick.
1. The "extinction" method
Let your baby cry it out. Put them in the crib at a certain time, after following a certain bedtime routine, and don't interfere until the next morning, no matter how much they yell. Followers of this method believe if a child learns that a tantrum will result in the appearance of a loved one, the behavior will continue into the future.
"The downside, of course, is that it’s unbelievably stressful for parents," writes Carroll. "Many can’t do it. And not holding fast to the plan can make everything worse. Responding to an infant’s crying after an extended period of time makes the behavior harder to extinguish. To a baby, it’s like a slot machine that hits just as you’re ready to walk away; it makes you want to play more."
2. The "graduated extinction" method
If option 1 is too intense, this might be the right move for you. In this method, parents gradually increase the amount of time they let their baby cry each night.
"On the first night, for instance, parents might commit to not entering the baby’s room for five minutes," Carroll explains. "The next night, 10 minutes. Then 15, and so on. Or, they could increase the increments on progressive checks each night. When they do go in the room, it’s only to check and make sure the baby is okay—no picking up or comforting. This isn’t meant to be a reward for crying, but to allow parents to be assured that nothing is wrong."
3. The "fading bedtime" method
The aim of the "fading bedtime" is to teach your child to fall asleep on their own at bedtime, so if they wake up in the middle of the night they know how to fall back asleep on their own.
"With fading, you temporarily set bedtime later than usual and preface it with a good bedtime routine," writes Carroll. "Your babies learn that bedtime is fun, and have little trouble falling asleep because they’re more tired than usual. Then you move their bedtime earlier and earlier, so that infants learn how to put themselves to sleep when they are less and less tired."
4. The "scheduled awakenings" method
Stave off middle of the night wakings by waking the child up 15 to 30 minutes before they usually wake up, then help them fall back asleep. Then, slowly phase these scheduled awakenings out.
5. The "parental education" method
This one is more preventative than the others, and focuses on working with your pediatrician on various approaches before sleep problems develop.
"The strongest evidence supported the extinction method and parent education (i.e. prevention)," Carroll explains. "Still, there was evidence that also supported graduated extinction, fading and scheduled awakenings methods."
So, no matter which methodology you employ, you're doing it right. And a good night’s sleep—when you eventually get one—will make it all better, no matter how long it takes.
