This is a touchy subject for some parents who suggest a "no cry" method, but we used the "progressive wait" approach suggested by Richard Ferber, MD who is "associate professor of neurology at the Harvard Medical School and director of the Center for Pediatric Sleep Disorders at Children's Hospital Boston." You can find details in his book: Solve Your Child's Sleep Problems and the thoughts below are based on my reading of the book.
Basically the idea is that your key problem preventing your child from sleeping through the night is that you put your child to bed already asleep, and he associates going to sleep with you cuddling with him. Everybody wakes up at various points during the middle of the night and if your child associates going to sleep with cuddling with you, rather than self-soothing, that is what they are going to need.
A second problem is that it is distressing to your child for you to have suddenly disappeared. One moment you're there, and the next (conscious) moment after waking, you are not there. It would be kind of like if every time you woke up in the middle of the night (and everybody does that often--you just don't remember it because it is so brief) and your pillow was missing from under your head and you had to retrieve it from the floor. That would be more of an annoyance to you than distressing, but the analogy is decent, and it would disrupt the quality of your sleep.
So what's the solution? Well, teaching your child to go to sleep without anyone present. Some folks just do a "cry it out" approach (you lay the child down and let them cry until they fall asleep), but Ferber recognizes the stress that has on the child and developed his "progressive wait" approach as a direct wait of teaching your child to sooth himself and involves less overall crying than the "cry it out" approach.
In brief, the Ferber method is as follows (similar to Beofett's answer above, but has some differences):
- Starting with a nighttime sleep period (not a nap), lay your child down awake after a short but pleasant bedtime routine. (The bedtime routine allows the child to start associating the routine with going to sleep and starts the processes of getting them in the "its sleepytime" mode). The bedtime routine is important!
- Say goodnight and leave the room. Your child will likely start to cry.
- Pick an amount of crying you're comfortable with (lets say 3 minutes in this example--it could be more or less) and after that amount of time go back into the room and reassure him (talk to him, rub his back) without picking him up or feeding him. Do this for 1 to 2 minutes and leave the room. Your child will likely still be crying at this point. Your goal here is not to stop the crying (although it's fine if he does stop crying); it is just to reassure him that you're still around for him.
- Your child will start (or continue) crying again. This time wait 6 minutes (3+3) before going in and reassuring him for 1-2 minutes and leaving.
- Keep repeating this pattern, increasing the the amount of crying by 3 more minutes. So on the third cycle you wait 9 minutes before going back in to reassure. (The amount of time reassuring never changes. It stays at 1-2 minutes). If you wish, you can pick a maximum length of waiting that you won't go over no matter how many cycles you've done (e.g., 21 minutes).
- Eventually your child will fall asleep, but will likely wake later in the evening and start crying for you. Every time he does, repeat this pattern of letting him cry 3 minutes before going in to reassure him and then waiting longer and longer (6 minutes, 9 minutes, 12 minutes, etc) in between the 1-2 minute reassurance times.
So that's night #1. It will be a hard night for you and your child. For my children, it involved around two hours of crying in total (between all of the wake ups), so pick a night to start this when either you or your child being well-rested the following day isn't critical. Many parents report it taking more time, some less.
Naps should be handled the same way and since the child's "drive to sleep" isn't as strong at nap time, you may hit a situation where you're child has cried for an hour and not fallen asleep. At that point, do the unthinkable and skip the nap. You'll have a crank child. Do not do a cuddly activity where they child might fall asleep. Try and keep them awake until the next nap time, but you might end up doing the next nap a little sooner than usual and that's OK during this period. When that nap time comes around do the same routine as stated above.
What happens on nights (and days) 2, 3, 4, etc? Well, it works the same way except you increase the minimum time you wait before going in to reassure him. On night #2, for our example, you would wait 6 minutes before going in to reassure him and then 9 minutes after that, and 12, etc. You also increase the maximum amount of time you wait (24 minutes instead of 21 using our example).
A few additional points:
- If you're child seems like he is going to fall asleep during one of the "reassurance periods," cut it short and leave before he falls asleep. This will cause him to start crying again, but remember the goal is to help him learn to fall asleep without your presence.
- You have to stick to your guns and follow it through if you're going to use this method. According to the book some parents will say something along the lines of "this method doesn't work. My child has been crying for 2 hours so I had to pick them up and stop the crying." While well-intentioned, the problem is that by picking the child up, it has encouraged the child to cry more and for longer periods knowing eventually the parent will give in and pick them up.
- It is ideal if you and your spouse/partner can switch off going in during the reassurance times, each going in every-other-time.
- If it sounds like your child is about ready to fall asleep, but it is time for you do do a reassurance session, you can delay it. If you child falls asleep, great! You don't have to be super rigid about the times--the biggest thing is that the wait time increases each time.
- After you've gotten your children sleeping on their own--you may have setbacks. If a young child is really sick or something big is happening, you may end up with a temporary situation where he may not be able to go to sleep alone. You may have to go back to cuddling to sleep, but keep it temporary. After the situation has resolved, and go back to the normal bedtime routine (of laying them down awake), if the child resists, you can start over with the Ferber method. The second time through will go super-fast for your child though--not nearly has much crying involved. He has already learned out to self-sooth, it is now just a matter of informing him (via not picking him up) that it is time to go back to doing it himself.
It is hard doing this--don't let anyone tell you otherwise. Hearing my children cry like that knowing I could end it quickly was very sad. I cried myself. However, my goal for this was to help my child get better sleep, not to help help myself, and it very quickly paid off. Night #1 is the hardest, and can involve hours of crying. Night #2 was better, but still somewhat brutal. Night #3 was a turning point for both of my children and involved much less crying. By night #4 things were pretty routine and there was a minimal crying. Around night #5 we could lay our children down and they would fall asleep on their own and sleep through the night. It was amazing! In the span of a few days we went from frequent wake ups to basically sleeping through the night. We keep our baby monitors turned way up, so we would still hear when they'd wake up in the middle of the night and adjust their position in the crib, but there wouldn't be any crying and they'd be back to sleep quickly. They got sooo much better sleep and were happier for it during the day.
