Is sleep training likely to help or harm your baby?

Getting a baby to sleep and settling them after night wakings can be one of the toughest challenges parents face. These sleep issues can disrupt parents' sleep and mental health. Some parents may turn to sleep strategies, previously called sleep training, to help their baby learn to settle themselves without adult assistance. Concerns persist about whether these strategies could harm the baby.

So, what does the evidence reveal? Sleep is a skill that must be learned, and while some babies pick it up easily, others need more assistance. When implemented correctly, sleep strategies can improve both baby and parent sleep, without harming the child or their relationship with parents. However, implementing these strategies can be challenging.

Sleep strategies are most effective for babies aged six months or older, once they can consume enough food during the day to meet their nutritional needs. Younger babies may still require daytime feeds. Parents should only use these strategies if their baby's sleep is a real problem – not everyone is willing to get up multiple times overnight, and that's acceptable too.

Establishing a good bedtime routine is crucial for the success of any strategy. This routine might include dinner, bath, pajamas, a story, a cuddle, and then into bed.

One common sleep strategy, known as the checking method, also referred to as controlled crying or controlled comforting, involves parents putting their baby into their sleep space (like a cot) drowsy but awake, then leaving them to self-settle. If the baby cries, the parent returns at increasing time intervals, like two minutes, then four minutes, and so on, comforting the baby until they calm down and remain awake, before leaving.

This process continues until the baby falls asleep or the parent feels they've had enough. The parent returns to comfort the baby without necessarily picking them up. This method typically takes three to seven nights for a baby to learn self-settling.

Another strategy is called camping out, or graduated extinction with parental presence. In this approach, the parent places a camp bed or chair next to the baby's sleep space. Initially, the parent pats the baby to sleep and then leaves the room. As the baby starts to settle with this method, the parent can sing or talk softly until the baby falls asleep instead of patting them.

Over ten to fourteen nights, the parent gradually moves the chair or camp bed a few feet away from the sleep space until they're outside the bedroom altogether.

Some parents worry that sleep strategies may harm their baby. Misinformation has made it difficult to assess the pros and cons. However, a study conducted over five years, involving 328 Australian babies, suggests that sleep strategies are both safe and effective. The study compared two groups of eight-month-olds: one (intervention) whose parents received advice on the strategies mentioned, and one (usual care) who received no advice.

The babies were followed until they were ten and twelve months old, and again at two and five years. The results showed that mothers in the intervention group reported fewer baby sleep problems and better mental health at ten and twelve months. By age two, mothers in the intervention group again reported better mental health, while parenting styles and child mental health were similar between groups.

At age five, there were no significant differences in child sleep, stress markers, emotional or behavioral scores, mother-child closeness, harsh parenting, or parent mental health.

In summary, sleep strategies in babies do not appear to cause harm or negatively impact the parent-child relationship.