The Best Ways to Help Children Sleep through the Night
Research separates opinion from fact in the heated debate on kids' sleep.
Posted Feb 27, 2019
March 1 is Baby Sleep Day, but for countless parents it will mean one more rough night of struggling with their child's sleep.
There's no shortage of strong opinions about the best approach for improving kids' sleep. On one extreme, parents are told they must let their child cry for extended periods of time before checking on him or her—some version of the "cry it out" method—and on the other they're told a crying baby must never be left alone.
Both extremes warn parents of dire consequences if they deviate from the guidelines. If they don't let their baby cry it out, they're supposedly setting up their baby for long-term sleep problems; if they do, they're told they're damaging the baby emotionally and weakening the attachment between parent and child. Thus on top of the stress of having a young child and dealing with the inevitable sleep loss, parents are left feeling unsure what to do and worried that whatever approach they take will be harmful.
Thankfully there are sleep experts whose main focus is on empowering parents to make the choices they believe are right for their child and their family, without shaming parents for not following a rigid ideological approach. I recently spoke with one such expert on the Think Act Be podcast—professor and psychologist Dr. Jodi Mindell, author of Sleeping Through the Night and Associate Director of the Sleep Center at the Children's Hospital of Philadelphia.
It's hard to imagine a more qualified person to assist parents in making baby-related sleep decisions. And yet Mindell doesn't appeal to her "expert" status when she offers sleep guidelines—she relies on research data. As such, she has no philosophical ax to grind about how parents are supposed to relate to their kids.
So what's myth and what's fact when it comes to helping kids sleep through the night? Let's start with the myths.
Myths About Baby Sleep Training
- There's one right approach that is best for every baby. Many of the ideologically driven sleep philosophies present a one-size-fits-all technique, with the types of warnings about noncompliance mentioned above. In reality, there is a lot of flexibility in how to help children sleep well. Indeed, the abundance of opinions about the right techniques suggests the diversity of approaches that can be successful.
- You will harm your baby if you let him cry alone in his crib. Multiple research studies have looked for evidence that letting a baby cry at night for some period of time has harmful effects. The results suggest that parents have no need to worry about negative consequences. For example, a recent study found that sleep training resulted in no attachment differences a year later compared to a control condition, and that cortisol-measured stress levels of babies who got sleep training actually declined. However, Mindell pointed out that some babies should not be left to cry, such as those with certain medical conditions or with a history of abuse or neglect. As always, the approach needs to be tailored to the specific baby and their family.
- If you don't do sleep training, your baby will never sleep well. A larger longitudinal study also found that there was no harm associated with sleep training at the 5-year follow-up—or lasting advantage. Children that had had sleep training showed no differences compared to controls on their emotional experiences, attachment, conduct problems ... or sleep problems. So why do many parents bother with sleep training at all? Besides the acute improvement in babies' sleep (and therefore parents' sleep), the study authors cited the significant benefits of child sleep training on maternal depression. And as Dr. Mindell noted in our discussion, more well-rested parents tend to have an easier time engaging with their kids during the day.
- Sleep training must follow strict guidelines. If you do choose to do some form of sleep training, many protocols are very structured, with specific prescriptions to follow. For example, parents are told they must leave a crying baby's room at night for increasing intervals of time (e.g., 3 minutes, then 5 minutes, then 10). Parents are also given strict guidelines about what's allowed when comforting a crying baby, often being told they must not pick the child up which will "reinforce" the crying behavior. In reality, there are endless variations on sleep training that can be effective. Some parents might choose to check on and comfort their child every two minutes, for example, whereas others might wait ten. Mindell emphasized the importance of "empowering parents to trust their gut and decide for themselves how they want to raise their child," including if and how they implement sleep training.
Facts About What Helps Babies to Sleep Soundly
So what's actually important for improving babies' sleep? The following principles have been shown to be effective in helping babies fall asleep more easily and sleep more soundly:
- A consistent bedtime. As with adults, babies benefit from having a set sleep schedule, which establishes a strong circadian rhythm so the body learns to expect sleep at the same time each evening. Keep in mind that earlier bedtimes tend to be better, despite some parents' hope that by putting their baby to bed later, she'll fall asleep quickly and sleep soundly. In fact, keeping a tired baby up past her normal bedtime usually just makes her cranky and wired, and more likely to struggle at bedtime.
- A predictable bedtime routine. Babies benefit from a winding down routine that lets them know bedtime is approaching. Research shows that a bedtime routine not only promotes good sleep but has additional benefits, like the close parent-child contact during reading, and learning about personal hygiene through bathing and tooth brushing. Dr. Mindell recommends including the same three or four activities each time—for example, a bath, reading two books, and singing two lullabies.
- Putting baby to bed awake. It's completely normal for sleepers of all ages to wake up during the night. Therefore the challenge for babies isn't staying asleep but being able to fall asleep on their own after waking up. The most reliable way to help babies fall asleep on their own in the middle of the night is to let them to fall asleep on their own at the beginning of the night, which means putting them in bed while they're still awake. In this way, the conditions at the start of the night are the same as those when the child wakes up in the middle of the night, so he won't require a parent to resettle him to fall asleep again.
- Sleep begets sleep. Just as putting a baby to bed later tends to backfire, skipping naps generally makes nighttime sleep worse. Rather than being so tired she sleeps through the night, the baby will be overtired and out of sync with her sleep schedule. Thus while daytime naps often contribute to sleep problems in adults, they typically improve the quality of nighttime sleep for babies.
Mindell and her Pediatric Sleep Council colleagues have created a free resource for parents called BabySleep.com. It's home to a wealth of science-based answers to common questions parents have about their child's sleep.
The full conversation with Dr. Mindell is available here: How to Help Your Baby Sleep through the Night.
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