Cry It Out Method Night Feeding
Leo Medrano for Sleep.com
After many sleepless tear-filled nights (for both you and your little one), perhaps you've decided the time has come to sleep train your baby. But it can be overwhelming to figure out where to start and which method to use. If you're wondering how to sleep train a baby, you might have come across an approach known as the Ferber Method.
The Ferber Method of sleep training is among the most popular. The Ferber Method was first introduced in 1985, by Dr. Richard Ferber in his book, "Solve Your Child's Sleep Problems." While there has always been controversy among experts regarding the efficacy and long-term effects of "Ferberizing" (using Ferber's methods to sleep train your baby), this method has been extremely popular in the 36+ years since the book was published.
The Ferber Method of sleep training is not merely "cry it out." Instead, it offers a graduated, step-down approach that helps your baby learn to self-soothe.
What is the Ferber Method?
The Ferber Method is one of many options for sleep training your baby. In the Ferber Method, parents help babies learn to self-soothe. Instead of feeding them, walking them, or offering other comforts when babies wake up in the middle of the night, parents train their babies to fall back asleep on their own.
This differs from extinction training, which is often referred to as the Cry It Out method. For Cry It Out, caregivers put the child to bed and then don't return until wakeup time, except for emergencies and designated night feedings. Ferberizing, on the other hand, allows parents to pop into their baby's room at timed intervals.
According to Patti Read, owner of Goldilocks Sleep Solutions and certified sleep specialist, "Both methods rely on the fact that your child is using crying as a way of letting out their frustration, but also will be able to learn to self-soothe and fall asleep after their crying is over."
Since these approaches are similar, some call the Ferber Method a "graduated extinction method."
Ferber method guide:
On the first night of sleep training with the Ferber Method, go through your typical bedtime routine with your baby.
- Put them in the crib when they're drowsy, but still awake.
- Tell your baby goodnight, leave the room, and listen for any fussing or crying.
- If your baby cries, go back in the room at the time indicated on the below Ferber Method chart. You should not pick up or feed your baby, but you can reassure them and pat them if you'd like.
- Repeat the above action at the indicated intervals until your baby is asleep.
Ferber Method chart and schedule
(Source: "Solve Your Child's Sleep Problems" by Dr. Richard Ferber)
Leo Medrano for Sleep.com
When to start the Ferber Method, or "Ferberizing"
In his book, Ferber suggests that his method can be successful for babies around five months and older. However, this could vary based on each baby's development.
Jamie Caldwell, pediatric sleep specialist at Caldwell Sleep Consulting, LLC, agrees with this time frame but warns parents to not begin earlier.
"Expecting a baby to sleep through the night, have lengthy naps, or be on an organized schedule [before] five months is simply unrealistic as their bodies are incapable before this age," Caldwell says.
But that doesn't mean that there is nothing to do until then. "Parents can start to practice a soothing routine, watch for sleep cues, and transition into a consistent sleep space as early as 6-8 weeks," she says.
You may also want to start weaning your child from nighttime feeding before you start Ferberizing.
A note on Ferberizing and nighttime feeding
By six months of age, most night feedings are for comfort rather than nutritional need, though Caldwell recommends working with your child's pediatrician to assess your baby's weight gain before eliminating a feeding.
"Night sleep is when we receive our most important, restorative sleep, and parents should avoid interrupting it," Caldwell says. "Ferber outlines a gradual schedule to decrease ounces offered and increase hours between feedings each night to wean a child off feedings."
So long as there are no weight or nutritional issues, working with your child to reduce night feedings and ultimately eliminate them will allow for uninterrupted nighttime sleep, an important developmental element. According to this study published in the Journal of Child Psychiatry and Psychology, infants who develop self-soothing skills have longer stretches of sleep, resulting in better sleep habits moving beyond babyhood. Sleep for infants is also associated with improved memory and language skills.
How long does the Ferber method take?
Although the crying may be difficult for parents to endure, the good news about the Ferber Method is that you should see results relatively quickly. "As long as the caregivers are following the method consistently, you should see some improvement after about three to four days, and after about seven to 10 days a vast improvement," says Read.
Read also explains that after a couple of successful nights, you may experience a setback which is a normal part of the learning process. Read says, "They may have one or two good nights of sleeping or not crying and parents feel great, but then they have a really rough night and cause parents to feel discouraged. This is normal. The following nights should continue to get better."
If after two weeks of consistently following the Ferber Method, your baby is still crying frequently throughout the night, there may be another issue unrelated to sleep and you should check in with your child's pediatrician.
Controversy: Is the Ferber Method harmful?
Perhaps most persistent is the misconstrued notion that Ferberizing is analogous with Cry It Out. In the second edition of his book, Ferber emphasized the difference between leaving your child to cry for prolonged amounts of time until they fall asleep and checking on them periodically to help them self-soothe and become better sleepers.
Criticism of the Cry It Out method also has to do with the theory that not responding immediately to those cries will cause a child harm. But Caldwell says Ferberizing your baby also means giving them the space to independently learn a skill.
And the importance of sleep on child development should not be underestimated. According to a comprehensive study conducted by the Sleep Research Society, since greater than half of the first year of life is spent asleep, "The concomitant growth and development that occurs during this time is substantial."
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Tips for success with the Ferber Method
In order to maximize your success with the Ferber Method, keep the following suggestions from Dr. Ferber and other sleep experts in mind.
1. Keep the baby's bedtime routine consistent
The most vital tip for success with Ferber is consistency in all things. Keep your baby's bedtime routine as uniform as possible. Bath time, reading a book while cuddling, and quiet time are all recommended components of a quality bedtime routine, which sends the message to your baby that it's almost time to sleep.
2. Set and follow the same wake time every day
Maintain consistency in the same manner you set the "okay to wake" time for morning.
3. Set an appointed time for night feeding
If you have not weaned off night feeding yet, Read recommends setting an appointed time slot for the night feed. "If the child is waking before that time, you should keep going with the method of progressive checks. If the child wakes crying and it is after the appointed 'ok to feed' time, then you would go in and feed, then proceed with the method for falling asleep again," says Read.
4. Pay attention to your child's cues
Caldwell has developed what she refers to as "the pause," a modification in her own practice of the Ferber Method. "At the end of each time interval, listen and process what your baby is doing. Has their crying decreased to an occasional babble of noise? Maybe they are rocking their head back and forth or rhythmically moving their legs. These are all indicators they are winding down and self-soothing. Consider extending the interval if this is happening. It means they're doing it; they're putting themselves to sleep!"
5. Plan two weeks ahead before Ferberizing
Whitney Roban, sleep specialist at Solve Our Sleep, advises against Ferberizing before you're totally ready and committed, in order to avoid falling back into old habits. Without having a plan in place, giving up is far too tempting. "Plan to begin the journey when you have a full two weeks in which your child can be home in the crib for all naps and for an early bedtime. If you are traveling, or have house guests, or someone in the family is sick, you should postpone sleep training," Roban says.
6. Make sure all the caregivers are on the same page
Next, Roban recommends getting your baby's entire team on board. "Make sure all caregivers agree to follow the newly created sleep [strategy] with 100% consistency. Sleep training will fail with anything less than 100% consistency" she says.
7. Stick with the plan
Roban also cautions against changing your plan out of fear, including fear of judgment. "There will always be someone to make you question your parenting choices," Roban says. "The naysayers are the most vocal and there will always be someone telling you that what you are doing is wrong or bad." Don't get distracted by the opinions of others, but rather keep your focus on your child and what their behavior is communicating to you.
And remember — you are doing the right thing! While it may feel stressful in the moment for both you and baby, studies show that there is no long-term impact on your child's health or yours, nor are there any attachment issues because you sleep train.
When to stop the Ferber Method
If parents find this method too overwhelming, perhaps due to their own sleep exhaustion, it is recommended they take a break or seek another method of sleep training. Give yourself permission to explore other options if Ferberizing isn't successful for you and your child.
Other methods of sleep training aside from the Ferber Method and Cry It Out include:
1. Faded Bedtime
This involves a more positive approach in which the parents "reprogram" nighttime routines. The basic principle is that a child (or anyone!) needs to be drowsy in order to go to sleep. Combined with creating a sleep routine, the first step to Faded Bedtime is successfully putting the child to bed on their own when they are sleepy, even if this means a later-than-preferred bedtime. The second step is moving up the established bedtime in 15-minute increments until you've achieved the desired bedtime for your baby.
2. Extinction with Parental Presence
Unlike the Cry It Out method, where the parent or caregiver simply puts an awake baby in the crib and leaves them to their own devices, Extinction with Parental Presence instructs parents to remain in the child's room with them as they fall asleep, and gradually moving further apart from the child each night.
3. The Pick Up Put Down (PUPD) Method
Similar to the Extinction with Parental Presence, this method has parents not only stay in the room with the child, but pick them up, give them pats, and place them back in the crib each time they fuss until they fall asleep.
Takeaway: Other things to know about the Ferber Method
"Parents should tune into their child's responses during checks and ask themselves, 'Is my child calmed by my presence? Does their frustration increase during checks?' If they don't like you in the room, get out of there," Caldwell says.
Keep in mind that check-ins can be stimulating for some children, as every time you enter their room there may be an increase in light, motion, and noise. "Some children don't have the sensory threshold for the frequent checks," Caldwell says. She recommends extinction training for more sensory-sensitive children.
Illnesses can also complicate sleep training. If your child becomes ill during sleep training, stop immediately and try again once they have recovered. Unless it's a very mild cold, illness may set back any progress or create negative associations. It's OK to take a break.
If the Ferber Method isn't working for you, Roban recommends not switching your routine within the same night. "Follow through on the method you initially chose that night and start a new method the next night. Or, you can pause the sleep training altogether and pick it up with a different method at a later time," Roban says.
Fear not — there is rest awaiting you at the end of your sleep training journey. Working with your pediatrician or a sleep expert will help your family find and stick to the best sleep training method for your baby, and you and your child will the happier for it.
Source: https://www.sleep.com/sleep-health/ferber-method
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