Ferber Sleep Training (Graduated Extinction) Definition
Dr. Richard Ferber is a pediatrician and the director of The Center for Pediatric Sleep Disorders at Boston Children’s Hospital. His “Ferberizing” approach was first made popular in his 1985 book entitled Solve Your Child’s Sleep Problems, which has since been updated and revised.
His updated book covers a range of solutions for issues, like bedwetting, sleepwalking, and nighttime wakings. Graduated extinction is what made his initial work famous and involves letting babies cry in progressively longer intervals.
But in a recent interview, Dr. Ferber says his view on leaving children to cry has changed. Now, he claims this approach is only recommended for parents who want to break their child’s bad sleep habits. For others, he says more gentle methods can work.
Differences Between Ferber and Cry-it-Out Method
The “cry-it-out” method is exactly like it sounds—you let your baby cry until she falls asleep. If it sounds intense, it’s because it is. This approach can cause a lot of distress for babies and parents and doesn’t address the root cause of why your tiny tot is waking at night.
In his updated book, Dr. Ferber aims to help parents understand some of the biology of sleep and how to prevent and address various problems that can arise. His approach of letting babies cry only applies to those with habits that need breaking, including being rocked, fed, or otherwise parented to sleep.
Another difference between this approach and extended crying is that parents are instructed to check on their baby at timed intervals. This starts at 3 minutes, then 5 minutes, and eventually 10 minutes the first night. Being able to temporarily check-in may bring comfort to both parents and babies.
The Ideal Age to Start Sleep Training
Too early, and your little one doesn’t have the skills to self-soothe. Too late, and habits may already be set. The ideal age is somewhere in between.
Begin After Your Baby Turns Six Months
Around six months is an ideal age to address night wakings, since most babies are capable of self-soothing and may only need one to two feedings overnight.
Start Before Your Infant Becomes a Toddler
While it’s not impossible, addressing issues in toddlerhood can be a lot harder and take a lot longer than when they’re young.
Other Things to Know
Before you settle in on any method, it’s important to do some research and figure out what’s right for your family. Here are some things to keep in mind:
Extended Crying Might Harm Babies
From a biological perspective, mothers and breastfed babies are hardwired to sleep together for feeding, comfort, and warmth. Research has even shown that this arrangement allows them to sync heart rate, breathing, and more. When babies cry, hormones and other chemicals in a mother’s brain send alarm signals that prompt them to immediately respond.
Many critics of rigid sleep-training methods claim that extended crying may harm babies and lead to damaging psychological effects. Well-known sleep expert and pediatrician Dr. Sears claims this lack of comforting breaks the parent-child bond and causes babies to lose trust in the value of their cry.
While some research shows that crying approaches are effective, others say these studies are inadequate and point to other research that extended crying isn’t safe. Unfortunately, we lack the proper scientific studies to say with certainty whether this method causes any long-term harm.
Progressive Waiting Doesn’t Teach a Child How to Fall Asleep
Babies who are left to cry eventually fall asleep because crying is exhausting and scary, not because they suddenly have mastered the skill of independent sleeping. While this method may work temporarily, it doesn’t teach children how to fall asleep. That’s why in many cases, the night wakings eventually return.
Importance of Sleep Routine
Regardless of which method you choose, the most important things that you can do is maintain a consistent bedtime routine. Just like adults, babies thrive on routine because it helps them to know what comes next. A pre-bed routine can also help to signal hormones in your child’s brain that sleepy time is near.
Your routine doesn’t have to be elaborate; just make sure that it’s relaxing, consistent, and ends with your baby in her crib drowsy but not fully asleep. This last element is key because babies who are parented to sleep are more likely to need help falling back asleep when they wake up at night.
Babies have shorter and lighter sleep cycles than adults, and it’s during these transitions between cycles that waking is likely to happen. If you rocked your little one to sleep, he’ll wake up and expect the same. If you rock him until he’s drowsy but awake and let him fall asleep on his own, he’s more likely to be able to go back to sleep without your help during the night.
A bedtime routine is one example of a positive sleep association, meaning your baby learns to associate things like a bath and reading books with bedtime. According to science, it works! A study involving 10,085 children from around the world found that regular bedtime routines before 12 months of age lead to better sleep as preschoolers.
The Method Isn’t Suitable for:
Children Afraid of Being Alone
Progressive waiting doesn’t address nighttime fear and anxiety. In fact, it may make it even worse. Children who are afraid need comfort and reassurance, not more fear. If your child gets so upset that she hyperventilates, vomits, or holds her breath, this is definitely not the right approach for her.
Certain Baby Temperaments
Babies with cautious or sensitive temperaments require more gentle methods, such as no-cry approaches or the fading technique.
Gentle and Attachment Parenting
Gentle and attachment parenting encourages a strong parent-child bond during the day and at night. This usually includes co-sleeping or room sharing.
Infants Suffering from Sleep Disorders or Medical Conditions
Even babies can suffer from medical conditions and sleep disorders that increase nighttime waking or make it more difficult to fall asleep. For bleary-eyed parents, it can be challenging to know if your little one isn’t sleeping because of a bad habit or because he has something underlying going on. Ferberization only addresses habits and enforcing independent sleep, nothing else.
Some of the conditions that could be affecting sleep include:
- Night terrors
- Pediatric Sleep Apnea
- Circadian rhythm disorders
- Breathing disorders (asthma, etc.)
- Restless leg syndrome
- Pediatric insomnia
Other possibilities include a bedtime that is too early or too late and lack of sleep. Contrary to what you may think, children who are overtired have a harder time falling and staying asleep. Skipping naps in hopes that your babe will be sleeping through the night is likely to backfire.
Choosing an appropriate bedtime and ensuring your little one is getting the right amount of sleep for her age can make a big difference in improving nighttime rest.
Ferber Method Chart (Steps)
Ferberizing can happen anywhere, but a lot of parents find it easier to implement once they’ve successfully transitioned baby to the nursery. If you follow the American Academy of Pediatrics recommendations, this usually happens between 6-12 months. A lot of change at once can be overwhelming, so wait a few weeks after this transition before beginning.
Step 1: Implement a calming bedtime routine that involves activities, like a warm bath, putting on pajamas, brushing gums, and reading stories.
Step 2: Once your little one is used to this routine, start putting him in his crib drowsy but awake.
Step 3: Say goodnight and leave the room.
Step 4: On the first night, if your baby cries, wait three minutes before going in to check on him.
Step 5: Once you’ve made sure that he’s okay, say goodnight and leave the room again. This time, wait five minutes.
Step 6: If he cries, go in and check on him, then say goodnight. This time, wait 10 minutes. Every subsequent time after that, wait 10 minutes.
Step 7: On the second night, follow your bedtime routine. After tuck-in, wait 5 minutes before going in, then 10, then 12.
Step 8: For every night that follows, gradually extend the length of time you wait to check-in according to the chart below.
Is Customizing OK?
While many claim that seeing success depends on following this chart exactly as laid out above, others say it’s fully customizable depending on your situation. If you or your baby aren’t adapting well to longer intervals, you could shorten them or only extend them over a week instead of a day.
Every baby is different, and their ability to handle the stress of crying is too. The same goes for parents! While some parents can reason that crying will lead to improved rest, others have a very hard time with hearing their little one cry.
Ultimately, you should do what feels best for you. While customizing may mean training takes a little longer, it’s worth it if you see success. In the end, make the decisions that means both you and babe aren’t feeling overly stressed.
Pros and Cons of Graduated Extinction
Every method has its pros and cons, and being aware of these can help you to decide which approach is right for you and your family.
Rigid, extinction-based methods, like cry-it-out and Ferber, have been shown to reduce problematic bedtime behavior, like tantrums, trouble falling asleep, and frequent nighttime wakings. Some experts claim they work faster than other methods too.
Many parents also say that their level of stress is reduced once their tiny tot is sleeping better at night. Another huge benefit for parents is that they are sleeping better too.
For parents who struggle with the idea of leaving their baby to cry alone, progressive waiting is a good alternative to crying approaches because parents can comfort at timed intervals.
One huge drawback is that Ferberizing can be very stressful for parents and babies. We don’t yet know if extended crying can have long-term effects on children.
This method is also not a good fit for certain temperaments and parenting styles.
Some experts claim that while it works the fastest, it eventually stops working and things go back to square one.
If you’re ready to give it a go, these tips may come in handy along the way.
- Research, research, research. Before getting started, read Dr. Ferber’s books, and make sure that you fully understand how Ferberizing works.
- Make sure that your baby is ready for sleep training. This includes being six months of age, not sick, not working on a developmental milestone, and showing signs of self-soothing (like bringing hands to the mouth).
- Make sure that you are ready. Sleep training is hard and requires a lot of commitment, so evaluate your readiness before you start.
- Make sure this method is right for you and your baby. It works better for babies with easy temperaments and parents with an authoritarian parenting style.
- Block off time on your calendar. You’ll need at least two weeks where you are not traveling and can be home for all naps and bedtime.
- Get help! Listening to your baby cry is hard, so make sure that you have a partner, family member, or friend to support you along the way.
- Make a plan and stick to it for at least two weeks. This is the minimum amount of time to see some real change.
- Be prepared for setbacks. They happen to everyone!
Is pacifier a suitable sleep association?
Pacifiers are recommended for reducing SIDS and can help with weaning and minimizing the suck-to-sleep association with feeding.
What to do if the baby gets hungry during sleep training?
Hungry babies should always be fed, regardless of if you are undergoing training. It is possible to train and continue to feed your little one at night.
For bleary-eyed parents, sleep training can provide hope that there is light at the end of their tunnel of exhaustion. Choosing the right method for your family can make a world of difference in seeing success and reducing stress.
If you’re ready to give Ferberizing a try, our tips and tricks should help to get you on your way. And if this approach isn’t your cup of tea, don’t worry. There are plenty of other ways to teach your baby the ABC’s of zzz’s.
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Jill Zwarensteyn is the Editor for Sleep Advisor and a Certified Sleep Science Coach. She is enthusiastic about providing helpful and engaging information on all things sleep and wellness.