Our first in a series of blog posts regarding sleep training methods and techniques. First up, The Ferber Method. Misconceptions be damned lets get to the bottom of this slightly controversial method.
OK! You're about 4+ months behind on your sleep and the time has come to get some solid sleep in. Unfortunately, many babies are just fine with waking up during the night until you teach them otherwise. That’s why many parents turn to the Ferber method, a form of sleep training that encourages babies to sleep through the night.
In 1985, Ferber wrote the best-selling book Solve Your Child's Sleep Problems (which he later updated in 2006), essentially there are two key ideas behind the Ferber Method that are commonly mixed up or combined. Lets unpack them one by one.
Step 1: Sleep Associations
Sleep associations are the things that you child associates with falling asleep or how they're used to getting to sleep. Unlearning poor sleep associations and developing good sleep associations are two of the keys to the Ferber method and to a good night's sleep.
Specifically, Dr. Ferber states that you should teach your child to fall asleep on their own and that they shouldn't associate falling asleep with rocking, having their back rubbed etc, as they will likely need that extra help to fall asleep again any time they get into a light sleep phase in the middle of the night. Children who have good sleep associations and who fall asleep on their own usually fall right back asleep without any help, or just keep sleeping, when they go into a light sleep phase.
So the first part of the Ferber method is that you make sure that you aren't one of your child's sleep associations and that you don't hold, rock, or talk to your child as they go to sleep, etc. Essentially, any condition that your child can't reestablish on their own in the middle of the night would be a poor sleep associations.
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Step 2: Progressive Waiting
The other big part of the Ferber method is the Progressive Waiting Approach to dealing with refusals to go to bed and waking up in the middle of the night or what some people think of as the "cry it out" part of the Ferber method.
Once you have eliminated any poor sleep associations, have developed a good bedtime routine, and understand the importance of good sleep associations then you have to know what to do when they don't want to go to bed or wakes up.
The Ferber method recommends that you let your child cry for progressively longer amounts of time before briefly checking on them. Keep in mind that your goal when you check on them is to simply reassure yourself that your child is okay and reassure your child that you are still nearby, and it is not to get them to stop crying or to help them fall asleep.
The process involves checking in on your child at gradually increasing time intervals.
For example, on the first night you might check on your child after they have been crying for 3 minutes, 5 minutes, and then 10 minutes, with 10 minutes being the maximum interval if you have to keep checking on them, although the intervals would restart at 3 minutes if he wakes up again later. You would then increase the intervals by a few minutes again the next night, although Dr. Ferber states that you can be flexible with these intervals if you don't feel comfortable waiting that long, as long you increase the intervals each time.
Using this method, Dr. Ferber claims that most kids are sleeping well by the third or fourth night.
Crying and the Ferber Method
So there is some crying when you use the Ferber method, but Dr. Ferber states that "only rarely will a child cry for several hours." More typically, your child will fall asleep during one of the earlier intervals, which depending on the night, you are checking on them every 10 or 15 minutes.
Do kids cry when you use other methods to try and help them sleep better? Of course, they do. Even with a "no-cry" method, your child is still going to cry every time they wake up. The difference with most of those methods versus the Ferber method is that they usually advocate that parents calm their child as soon as they start crying, without any waiting period. But since the goal is to teach your child to fall asleep on their own, even with these other methods, they will likely just start crying again when you put them back down in their crib or bed, or once you leave their room until they develop good sleep associations.
But keep in mind that the short periods of crying during the Progressive Waiting is not the same as letting a child "cry it out" all night until they fall asleep.
And if you add up all of the crying that your child now does when they wake up in the middle of the night, especially if they keep doing it for many more weeks or months, it will likely far exceed what they might do using the Ferber method. Also, most experts don't think that this crying is harmful or that it is out of fear, but rather because the child is frustrated that they can't get to sleep.
Ferber Method Tips
The Ferber method works well if you follow the plan closely. When it doesn't work, it is usually because a parent isn't actually following the actual Ferber method, like for example they are letting their child cry without checking on them or they aren't letting their child fall asleep on their own.
Another reason that the Ferber method sometimes doesn't work is that a parent might be inconsistent with the method, using Progressive Waiting for a few days, but then giving in and rocking their child to sleep because they are so tired themselves.
To increase their chances of success with the Ferber method, you should:
Read all of Dr. Ferber's book "Solve Your Child's Sleep Problem" before you even think of getting started.
Start during a time when you can afford to lose some sleep yourself.
Be consistent with the Ferber method once you get started, which means doing the same things at naps, bedtime, and if your child wakes up in the middle of the night.
Move your child's bedtime to the time when they typically fall asleep. For example, if they have an 8:30 pm bedtime, but their bedtime routine gets dragged out to 9:30 pm with crying and your child is getting out of bed, then move their bedtime later, saying goodnight and starting your Progressive Waiting at about 9:30 pm.
Learn to set limits, such as getting your child to stay in their room at night, not reading another bedtime story, or getting them another drink of water once they're in bed - which is another important part of the Ferber method.
Use stickers or other reward systems for older children who stay in bed and give up poor sleep associations.
Consider using a countdown timer, like on an iPhone, as you apply the Progressive Waiting Approach.
Rethink your approach if you aren't seeing improvement after three or four nights.
Ferber Method Q&A
When Can You Start the Ferber Method?
Dr. Ferber stresses that you shouldn't start too young, but that you can likely start using these methods at around five months of age if your infant isn't sleeping well since that is a time when many infants are able to sleep through the night.
When Should Babies Be Able to Sleep through the Night?
Most infants can sleep through the night by the time they are about 5 months to 6 months old.
Is Sucking on a Pacifier a Good Sleep Association?
Not usually, especially for toddlers and preschoolers, since if the pacifier falls out, then they likely will cry out for you in the middle of the night.
Is the Ferber Method for Everyone?
No. Just like children have different temperaments, parents may have a temperament that would make another method better suited to them, such as Elizabeth Pantely's "No Cry Sleep Solution" or "No Cry Sleep Solution for Toddlers." Also, the Ferber Method of Progressive Waiting is mainly for kids who have poor sleep associations. It likely won't work as well if your child is sleeping poorly for some other reason.
How Long Does the Ferber Method Take to Work?
Dr. Ferber states that you should usually see "marked improvement" in your child's sleep "within a few days to a week."
This blog post has been adapted from an article written by Vincent Iannelli, MD. https://www.verywellfamily.com/the-ferber-method-dr-ferbers-sleep-book-2634262