Here is how to get your baby to sleep well in just 3-4 nights:
EXTINCTION: Extinction (you are extinguishing the habit expectation that crying out always brings parental attention) means that after a soothing bedtime routine at sleep onset, and except for feeding, changing, and any suspicion of medical distress, you let your baby fuss or cry without time limit until the morning (Blog Posts 25 and 26). Extinction does not harm your baby (Blog Post 71).
- It’s never too early to start. The earlier you start, the better (Blog Posts 49, 57, 67, 105–107, 115 and Parents’ Reports #1).
- Leave the room after you put your baby down; no ‘parental presence’ (Blog Posts 16 and 77).
- Temporarily, the soothing bedtime routine is super-early. You begin the bedtime routine at night early enough so that you leave the room (the expected falling asleep time) at 5:30pm, or perhaps 6-6:30pm if there is a long afternoon nap that begins before 3:00pm. The earlier the bedtime, the better. The early bedtime is essential to prevent heightened neurological arousal (Blog Posts 171 and 172) that makes it difficult for your baby to fall asleep.
- No nap is allowed to start after 3:00pm to achieve the super-early bedtime. A nap that begins before 3:00pm is allowed to continue; you do not wake your baby. If there is variability in afternoon naps, then the expected falling asleep time, while still occurring super-early, might vary from night to night.
- Under 4 months of age: Do whatever you can to maximize day sleep and minimize daytime crying (brief intervals of wakefulness, rocking, carrying, pitch black room, noise machine, etc.).
- Over 6 months of age: Attempt to impose a biologically age appropriate nap schedule: Mid-morning and/or mid-day naps.
- Between 4-6 months: Naps are developing; do A. or B. (Blog Post 95).
- Improvement will be sequential: Night sleep will improve first, then the midmorning nap second, and finally, the midday nap third. (Blog Posts 155 and 161).
- When naps become regular and long (Blog Posts 173 and 174), then the bedtime may be moved later, based on drowsy signs (Blog Posts 9 and 115X).
Hi Dr. Weissbluth! I really enjoyed your book and it has helped my wife and I feel prepared to start sleep training our 8 week old daughter (6 weeks old from due date). We are planning to try the extinction method. I understand the guidance regarding overnight feedings, but what happens when she inevitably ends up with a wet/dirty diaper in the middle of the night and starts crying because of that? Do we change her without social interaction in order to keep her comfortable? Or would that be considered intermittent reinforcement and therefore, we should we leave her in a soiled diaper overnight?
Try to always respond to your baby when wet, soiled, hungry, or when suspicious of distress. In the beginning, sometimes you will go to her when you think she is wet/soiled and she is not, but after a while you will become better in making this judgement call. Alternatively, put a very thick coating of zinc oxide paste on the diaper region to protect her skin from urine or stool and go to her much less often, knowing that no diaper rash will occur. Mineral oil is helpful to remove the zinc oxide paste. How does this sound?
This is very helpful – thank you! We’ll give it a whirl
Hi Dr. Weissbluth–I’ve been following your advice since day 1. It’s been super helpful, and so far our baby has been a great sleeper. He is about 14 weeks and so far has napped often and up to now has had no issue with an early bedtime (6 pm) and sleeping until 5/6 am with only one night feeding (breastfeeding).
However, within the past week he’s developed this habit of waking up 1 hour after he goes to bed and crying fairly hysterically for another hour. There have been no issues with him going to bed, and he’s wanted to go to bed at 6 pm since he was 8 weeks old. We have not done full extinction yet but we let him cry for 10-15 minutes at a time right now. He is a really easy going baby and almost never cries like this, so it is very distressing to hear and not something we’ve ever had to deal with. At first I thought maybe he was growing and was hungry and will sometimes nurse him when he does this, but that doesn’t really work. We try to just give him his pacifier and leave the room with minimal interaction but he’ll still be up and cry and cry. Nothing else seems to be the matter–he’s got a dry diaper, he’s eaten well throughout the day, had a lot of naps (at least 5-6 hours of naps during the day) with no issues. I’ll also say that he is still tired–when we go in and give him the pacifier his eyes are heavy, so I know that he’s still needing to sleep and the bedtime isn’t too early.
Once he is asleep, he wakes up once for a feeding and then has no issue going back to sleep after.
He’s currently sleeping in a snoo. I’ve had him nap in a pack and play, and he naps fine out of the snoo as well.
Do we need to try a full extinction method when he does this? Is he just waking up because he realizes we’re not there, and he’s trying to get us to comfort him?
Thank you!
Please describe a typical nap schedule.
How does he look (mood and behavior) when he is alone with toys and no screens and no parental interaction between 5-6pm?
On a good nap day: Wakeup around 6 am/6:30 am, first nap around 8-9:30. Second nap around 11-1ish. Third nap around 3-4. There might be another short cat nap between first and second nap or second and third nap some days if he’s not sleeping a full hour or hour and a half in his first nap or full two hours in his second nap.
From 4-5, he’s a happy camper. I can leave him in his play set by himself and he’ll be fine. But between 5 and 6 pm if he is just left alone, he starts getting fussy, rubs his eyes, seems tired and hungry, stares off into space. He will even start fussing in his swing a bit unless he’s given a pacifier, at which point he’ll just stare off into space. So I start getting him ready for bed around 5:20/5:30.
Thank you,
Alexis
“But between 5 and 6 pm if he is just left alone, he starts getting fussy, rubs his eyes, seems tired and hungry, stares off into space. He will even start fussing in his swing a bit unless he’s given a pacifier, at which point he’ll just stare off into space.” This is proof that his current fall asleep time is too late given his age and his current daytime sleep quality. Hi is going to a higher state of neurological arousal which is causing hime to have his new waking up 1 hour after he goes to sleep because of his accumulated sleep debt. Do everything that you are currently doing but do not let a nap start after 3pm and begin all your nighttime soothing and feeding so that you are leaving the room, lights out, at the expected fall asleep time of 5:30. This super-early bedtime is temporary and over the next several weeks, the naps will lengthen and when this occurs, the bedtime might be moved back to 6ish based on his mood and behavior between 5-6pm. Does this help?
Thank you so much–we will try that!
Just an update–we tried this the past few days and it has worked! He will still rouse after an hour but he’s not hysterical and goes right back to sleep with a pacifier. Thank you again so much Dr. Weissbluth!
You are welcome. Spread the word.