If you have not already done so, please read blog posts 1-5 that describe how sleep is important and beneficial. I will post specific information for parents and children based on my book, “Healthy Sleep Habits, Happy Child.” Please do not be put off by my book’s length. This is a reference book. Read only the topic of interest to you.
Blog Posts 99 and 100 describe studies that show how impaired sleep in children causes mental health concerns. To prevent mental health issues, start helping your child sleep well early. How early is early? Self-soothing can be taught to newborn babies (Blog Post 16). Baby sleep training can begin in young infants (Blog Posts 49 and 67). By starting early (Blog Posts 105–107), many adverse effects may be prevented, especially mental health concerns.
A 2020 study followed 4,500 younger children from birth to age 10-11 years. They were studied every other year. Mothers were asked: ‘How much is your child’s sleeping pattern or habits a problem for you? Mothers’ responses were:
A large problem
A moderate problem
A small problem
No problem at all
Not sure/don’t know
At 10-11 years of age, the mother and teacher reported on:
Internalizing concerns: many worries, often seems worried, often unhappy, downhearted, tearful.
Externalizing concerns: often loses temper, often fights with other children or bullies them, restless, overactive, cannot sit still for long.
Compared to those with no sleep problems, children with persistent high levels of sleep problems experienced greater internalizing and externalizing symptoms.
At 10-11 years of age, children with persistent low levels of sleep problems exhibited small psychosocial and academic impairments.
These results are similar to those described in Blog Post 57. For children who were followed for 8 years (between 6-14 years): A subgroup of children (20%) was identified as having persistent short sleep between 6-14 years. “Temperament negative affectivity and low parental emotional availability predicted membership to that group.”
Hello, doctor! I’m from Brazil, I would like to know if it is safe to apply the gradual extinction method to a 4-month-old baby?
Please read Blog Posts 105-107 to better understand why it is safe and effective!
Hi Dr Marc,
I would like to find out if allowing a baby to cry through extinction still promotes the learning of self soothing even if the baby does not successfully fall asleep?
If we leave our 6 week old baby to cry every now and then for 5,10,20 mins and he does not manage to fall asleep in this time, is it a wasted effort or does he still learn some self soothing in the process regardless?
Kind regards,
Lorraine
I think that sometimes allowing your baby to cry and to allow varying durations of crying before going to your baby and at other times not allowing your baby to cry is akin to “intermittent positive reinforcement” which will teach your baby to cry longer and louder in order to receive your soothing. This is sometimes been called ‘slot-machine psychology’.
If parents are able to do extinction as described in my book, it always works in neurotypical children.
Does this help?
Thank you Dr Marc.
We did exctinction with my daughter at 3 months according to your book and she is a great sleeper since.
Both my husband and I are considering doing extinction at two months with our new baby. In some way we have been ‘testing the waters a bit’, when struggling to get him to sleep, but thank you for pointing out that this may be more harmful than good.
Do you think extinction at 2 months is a good time to start? In that case we will have to do it thoroughly and for now not let him cry for short periods until we are ready to do it properly.
I am currently trying drowsy but awake with him when I can, it has worked sometimes.
Specific family values and circumstances are probably more important than just the age of a child when considering extinction.
My general advice is, at 6 weeks of age, to move the bedtime earlier (based on drowsy signs) and sometimes a temporary super-early bedtime really helps with night sleep; the good quality night sleep produces good quality naps to develop around 3-4 months of age and when good quality naps are in place, the bedtime might be moved a little later.
The most common problem with cild #2 is that child #1 distracts parents at night and subtle drowsy signs are not noticed and thus the bedtime for child #2, after 6 weeks of age, is too late.
Thoughts?
Thank you Dr Marc,
We have implemented a 17.30 bedtime as per your books recommendations for the past two nights and I think it is going well so far, however I feel it is too soon to tell. I hope to keep this up going forward. So far we have not had a fussy baby at all in the evenings! Thankful for that.
My asking about the 2 month age range for extinction is because from mid February I will be working two half days per week, and he will therefore be at home with our nanny during this time. It will be important for him to have self soothing skills by this time as our nanny has to manage two children alone.
I hope to continue with the early bedtime, many naps and trying to put him down drowsy but awake from time to time. Is there a chance that this will eliminate the need for extinction later on?
YES. Because of your experience, follow these guidelines and there will be no need for extinction:
1. Start Early.
2. Many hands. Get Father on board. More people doing the soothing to sleep makes your baby more adaptable.
3. Many naps. Brief intervals of wakefulness between naps; even 30-45 minutes
A. 2 hour rule: The period of wakefulness is always less than 2 hours; sometimes, only 40-60 minutes.
B. Brief intervals of wakefulness prevent Pre-sleep Arousal (Blog Posts 171, 172, 204).
C. No pre-sleep arousal means it is easier to fall asleep and stay asleep; that is, Sleep Begets Sleep (Blog Post 173).
4. Drowsy but awake (Blog Posts 83 and 115X). Don’t overthink this If colic is present, wait until 2-4 months.
5. Leave the room after putting baby down to sleep (Blog Post 16).
6. Ignore non distress sounds (Blog Post 11) at night.
7. Increase ‘cry tolerance’. When your baby makes non-distress sounds or very quiet crying and you think your baby is not wet, soiled, hungry or in distress, delay your response 5-10 seconds to see if your baby settles back to sleep unassisted. It is best to have a very brief delay in the response. (Blog Post 205).
8. Use low intensity soothing in the middle of the night (Blog Post 145).
9. Bedtime routines, every night if possible (Blog Post 10).
10. At 6 weeks of age, counting from the due date, not the birth date, early bedtimes, sometimes even 5:30pm. Maybe do not allow a new nap to begin after 3:00pm. The brain’s night sleep schedule begins. The longest single sleep period is longer and occurs in the evening.
11. At 3-4 months of age, synchronize nap opportunities with nap rhythms. The brain’s daytime sleep schedule begins. Protect a quiet and dark nap opportunity for a mid-morning nap and later, a mid-day nap, +/- a 3rd afternoon nap.
12. Don’t be a slave to a sleep schedule. Enjoy your family! Social sleep exceptions might occur 1-2 times a month.
Amazing, thank you so much.
I will print these notes out and keep them handy with me so as to keep track of the why and the how.
Point 7 is something I will also make more of an effort to implement. I have been doing this already in some form, and have seen the benefits as many times he settles back to sleep to my surprise.
I will also read the blog posts on pre-sleep arousal as the concept is new to me.
Thank you! Appreciate the help. We have seen amazing results with our first daughter implementing the advice from your book and I look forward to seeing how things unfold with our son.
Please look at Blog Post 205 for more information on #7.
Please consider writing a narrative report regarding your first child and going forward with number 2 and place it here for me to use as a Blog Post. Many mothers would be more attuned to your voice than mine. In particular, with your second baby, you might discover that you will never have to really do extinction because you are following a healthy sleep routine. It is a misconception that all children need to learn to sleep by letting them cry. These 12 items will work for every neurotypical child. Maybe a colicky baby will develop healthy sleep habits a little later or a little slower but for the remaining 80% of children, healthy sleep is always obtainable without crying.
If you do write a narrative report, please include the role of the father ( + or -).
Yes Dr Marc, I will definitely write a report and post it at the end of this week. Thank you.
Dr Marc,
I would like to clarify one thing regarding the 12 principles mentioned above.
Does the use of a pacifier alongside these still allow for a baby to learn self soothing or does it stunt the ability to learn self soothing, if being used for point 4 (drowsy but awake) or would you recommend to implement these without a pacifier for best results?
Pacifiers are fine (see pages 181-182).
Our daughter Christina was a very fussy baby, the only way to get her to sleep in the day was to nurse her nonstop. The moment the nursing paused, she would immediately wake up and cry. Then, every evening, like clockwork, from around 6pm the fussing would turn into inconsolable crying or rather screaming that lasted 3 to 4 hours. My husband and I tried everything to soothe her. I then started to put her in the baby carrier and walk around our thankfully large and scenic estate to try to soothe her in the evenings. I would walk for 2-3hours to keep her from crying and hopefully get some sleep. However, this solution was not perfect as the moment I would stop walking she would immediately start to cry again, sometimes she would cry the whole way. Then each night, she would finally, but very abruptly fall asleep around 9 or 10pm, most likely from pure exhaustion due to all the hours spent screaming.
Then when Christina was about 7 weeks old, a friend’s mom gifted me with a copy of Dr Weissbluth’s book after I confided in her about our struggles with our baby (I later on bought his newest edition for myself). She had read his book and applied it to her own children, some 20 years prior. Up until this point, we had no idea what was wrong with our daughter, but reading his book, particularly the portions describing a colicky baby, we quickly realised that this was what we were dealing with.
At about 9 weeks the colic ended, but she was still difficult and was still not napping during the day, most likely from all the sleep deprivation she had experienced. A week before 3 months of age, we were hopeless, and decided to test out the extinction method with her in order to help her nap better. The first night she cried for only 9 minutes and then was sound asleep. The days following that she cried harder and longer, but usually no longer than 45 minutes. Eventually we got to the point where we could put her in her cot while still awake, she would play a bit and then fall asleep on her own. She then started taking most if not all of her naps during the day. In hindsight I could have implemented a 17.30 bedtime to help things along even more, but I was not aware of the value of this at the time. She was now sleeping 8-10 hours stretches at night, which was very much needed for our family. She was a completely different baby, and finally we started to enjoy her more.
As the months passed, her night sleep became even longer. Once I realised I could give her an ultra early bedtime at 17.30, she started sleeping 14 hours per night around 8 months old which was a surprise to many.
She is now 2 years old is a good sleeper and a very well rested kid who is more than excited with life and full of joy!
We now have another baby, Daniel who is 6 weeks old and not a colic baby. With the guidance of Dr Weissbluth and a 12 principle approach he shared with me, we hope to altogether avoid having to use the exctinction method on him. Two of the major things we have started to implement are an early bedtime at 6 weeks (we aim for 17.30-18.30) and we have also been trying to put him down drowsy but awake when we can, usually having success in the morning around 7am. Furthermore, we aim to keep his awake time as short as possible and allow him to take many naps. At times when he has accidentally been awake for too long, my husband will often step in and try to soothe him with various methods to get him to sleep as quickly as possible.
Lastly, while we are not always able to perfectly achieve all 12 principle’s as we can’t control every thing that happens with our baby’s sleep, we do try our best to apply this approach in general.
Personally, something I have learnt through experience is that as moms we tend to interfere a bit too much with our babies and their sleep. An approach like this where we are willing to step back a bit and leave them to sleep is very valuable and does reap results.
I hope to continue in this way going forward and we hope that with implementing these things we can altogether skip having to use extinction on him in the months ahead.
Thank you Lorraine.
When I publish this, shall I change the names of your children or leave as is?
Would you like to add a note regarding the reactions or interactions with your family or friends regarding your sleep journey with either or both children because their influence can have either very positive or negative influences?
Hi Dr Marc,
Yes it might be best to change the names. There are a few other writing mistakes which you are welcome to edit as well.
Regarding interactions with family, when our daughter was taken care of by the her grandmother at times, a lot of effort had to go into explaining why adhering to her sleep schedule was important and to be followed closely. Only after much explanation was this respected by the grandparents.
Regarding friends, there have been mixed responses. Some felt that letting our baby cry is not right and it was told to us that they would never take this approach. Other friends struggling in desperation.with their babies sleep have come to us for advice and I have recommended your book to them, they have been very thankful for this and have also seen great results. I have a friend who is having her baby in January, and I have already shared the 12 principles you shared with me, as it is her first child and she is eager to establish good sleep habits. Another friend has a baby 3 days older than our son, I shared with her about the early bedtime around 6 weeks, but she has decided not to implement this as it is not convenient due to their family supper time.
We have quite a large circle of friends with babies around our age. Many times we will say no to a social event which occurs in the evening in order to protect an early bedtime, however many of them are very relaxed about the early bedtime and will not mind to participate in evening activities at the expense of their child’s bedtime. It can be awkward at times having to explain to them why we are so protective about the bedtimes, but we stand firm in our convictions regardless.
Perhaps if you let me know from the above what is relevant I could summarise it and add it to the narrative.
Thank you!
All of it is relevant and if you have the time, please add it to your original narrative. Also, if you wish, please add come comments about the role ( + or -) of your husband.
Our daughter was a very fussy baby, the only way to get her to sleep in the day was to nurse her nonstop. The moment the nursing paused, she would immediately wake up and cry. Then, every evening, like clockwork, from around 6pm the fussing would turn into inconsolable crying or rather screaming that lasted 3 to 4 hours. My husband and I tried everything to soothe her. I then started to put her in a baby carrier and walk around our thankfully large and scenic estate to try to soothe her in the evenings. I would walk for 2-3 hours to keep her from crying and hopefully get some sleep. However, this solution was not perfect as the moment I would stop walking she would immediately start to cry again, sometimes she would cry the whole way without ceasing. Then each night, she would finally, but very abruptly fall asleep around 9 or 10pm, most likely from pure exhaustion due to all the hours spent screaming.
Then when our daughter was about 7 weeks old, a friend’s mom gifted me with a copy of Dr Weissbluth’s book after I confided in her about our struggles with our baby (I later on bought his newest edition for myself). She had read his book and applied it to her own children, some 20 years prior. Up until this point, we had no idea what was wrong with our daughter, but reading his book, particularly the portions describing a colicky baby, we quickly realised that this was what we were dealing with.
At about 9 weeks the colic ended, but she was still difficult and was still not napping during the day, most likely from all the sleep deprivation she had experienced. A week before 3 months of age, we were hopeless, and decided to test out the extinction method with her in order to help her nap better. The first night she cried for only 9 minutes and then was sound asleep. The days following that she cried harder and longer, but usually no longer than 45 minutes. Eventually we got to the point where we could put her in her cot while still awake, she would play a bit and then fall asleep on her own. She then started taking most if not all of her naps during the day. In hindsight I could have implemented a 17.30 bedtime to help things along even more, but I was not aware of the value of this at the time. She was now sleeping 8-10 hour stretches at night, which was very much needed for our family. She was a completely different baby, and finally we started to enjoy her more.
As the months passed, her night sleep became even longer. Once I realised I could give her an ultra early bedtime at 17.30, she started sleeping 14 hours per night around 8 months old which was a surprise to many.
She is now 2 years old is a good sleeper and a very well rested kid who is more than excited with life and full of joy!
We now have another baby boy, who is 6 weeks old and not a colic baby. With the guidance of Dr Weissbluth and a 12 principle approach he shared with me, we hope to altogether avoid having to use the exctinction method on him. Some of the major things we have started to implement are an early bedtime at 6 weeks (we aim for 17.30-18.30) and we have also been trying to put him down drowsy but awake when we can, usually having success in the morning around 7am. Furthermore, we aim to keep his awake time as short as possible and allow him to take many naps. At times when he has accidentally been awake for too long, my husband will often step in and try to soothe him with various methods to get him to sleep as quickly as possible.
While we are not always able to perfectly achieve all 12 principle’s since we can’t fully control every element our baby’s sleep, we do try our best to apply this approach in general in order to set up good sleep habits from a young age.
While my husband works full time and is not always available to assist with our son during the day time, he has always been supportive in the form of being committed to ensuring we establish good sleep habits for both of our children in order to maintain a well rested and happy family. At times when we are invited to a social event which occurs in the evening, my husband has been very good at is saying “no” to many of these in order to protect our children’s early bedtimes. This can sometimes create some awkwardness between friends and family who do not do the same with their own children.
On the other hand we have had a good experience with the grandparents. Initlaly they were confused about why we have such a ‘strict’ attitude toward sleep with our children, but after some detailed explanation of the importance of sleep and the ramifications of poor sleep, they have come to accommodate us by arranging our family visits around our children’s sleep schedules and have even implemented the schedule quite nicely while looking after our daughter!
Drawing from the experience with my two children, I have come to think that as mothers we tend to interfere a bit too much with our babies and their sleep. As difficult as I know it can be, If one is only willing to take a step back, one might just be suprised by the results that this can reap in your baby’s sleep habits.
Our family is thankful for the guidance of Dr Weissbluth. We hope that by implementing these things we can altogether skip having to use extinction on our son in the months ahead and maintain a well rested family.
Thank you!
Your narrative report was published as a Blog Post on July 21, 2025. Would you be so kind and write a narrative update on your sleep adventure that I would post as a follow-up? Thank you.
Welcome!
Hi Dr Weissbluth,
I have a 14-week old and am currently reading Healthy Sleep Habits, Healthy Child. Our daughter is a great night sleeper – she was sleeping 10pm-8am but we’re now working to move her bedtime to 8:30 and it has worked on a few occasions. So on the best days she will sleep from 8:30-9:15, feed quickly, then sleep through until 7:45am.
We will continue to aim for earlier bedtimes. However, our main issue is with naps as it’s challenging to get her to nap in her crib. She sleeps very well in our arms but this isn’t sustainable. About half the time she will do her mid morning nap in her crib and it lasts 40 mins. For other naps, it’s very rare for her to nap in her crib and she will begin to aggressively cry.
Should I let her hard cry at 9am to develop the mid morning nap? If she sleeps 10-15 mins in her crib for a nap, should I pick her up and just let her nap on me to ensure she gets a nap at all? I’m a bit overwhelmed deciding what to do. Thank you!
Do you wish to go slow or fast to achieve healthy sleep?
Slow suggests more “gentle” to some parents and less crying per day and may take weeks.
Fast may take just a few days and maybe more crying per day.
Thanks… I think I’d prefer the fast approach as I think we’re becoming over reliant on her just napping on us.
Night sleep circadian rhythms begin around 6 weeks of age and nap rhythms begin around 4 months of age, so for now, the main focus is on night sleep.
Immediately move her bedtime to 5:30pm (she is bathed, fed, and soothed and you are leaving the room at 5:30PM). Do extinction over night with no more than two feedings at night. Don’t do this if you cannot commit to a 4-5 day trial. Keep a written record. This is a temporarily super earl bedtime to get her better rested in the morning so that she will nap better during the day.
During the day, temporarily. do whatever you can to maximize naps and minimize fuss/cry behavior (even contact naps). Keep the intervals of wakefulness very brief to prevent presleep arousals.
How does this sound?
That definitely is intriguing so I’ll discuss with my husband. I’m worried we may not be emotionally ready for that approach though, so perhaps I need to be more patient.
What would you recommend for the slower/gentler approach?
Thanks for fielding all these questions. I’ve learned so much from the book and with our next child will begin with better habits even earlier!
Q:What would you recommend for the slower/gentler approach?
Q:continue to move the bedtime earlier. Have Father take over nap duty on weekends and you leave the house and he attempts to use the crib more.
Okay thank you! We will start with that and if we don’t have luck then will move to extinction and the faster approach you mentioned.
Please carefully read the Chapter on Sleep Solutions to better understand your options and find one that comports with your values.
Hello Dr. Weissbluth,
I have recently started reading sections in your book and have been inspired to start helping my daughter sleep better. She is our first child and will be 3 months next week. I have a few questions if you don’t mind answering them, thank you so much.
1. Sometimes my daughter naps for 2.5–3 hours. Should I wake her up or let her wake up on her own? If a nap goes beyond 3 hours, should I wake her? How can I tell the difference between a healthy long nap and one that may interfere with the rest of the day?
2. Is it recommended to work on independent sleep for naps before 3 months of age, or should I focus only on nighttime sleep? I have been trying to encourage independent sleep for naps and limit each attempt to 10–15 minutes to avoid overtiredness. Does this approach make sense, or would it be better to stop trying for now and work on this later?
3. Sometimes my daughter falls asleep while nursing and remains latched for a long time, or even for almost the entire nap. Is this a problem for developing independent sleep? Should I unlatch her, or should I allow this in order to help her get good daytime sleep?
4. I am trying to encourage independent sleep at night using extinction. When I put her in the crib awake, she sometimes cries mildly and intermittently. If she does not fall asleep within 40–45 minutes, I stop the attempt and rock her to sleep. Could this interfere with her learning to fall asleep independently?
5. What is the best bedtime at this age? Should I prioritize her sleep cues or try to maintain a consistent bedtime?
Also, I wanted to send you her schedule from yesterday and see if you have any tips for me.
Wake window to test: 1h45m
Woke up: 6:40 AM
Fell asleep: 8:45 AM
Actual wake window: 2h05m
Nap: 1 hour (mostly contact napping, with a little time in the crib; we left her in the crib for 15 minutes)
Wake window to test: 1h50m
Woke up: 9:45 AM
Fell asleep: 12:02 PM, woke up at 12:17 PM
Fell asleep again: 12:20 PM, woke up at 12:35 PM
Fell asleep again: 12:40 PM, woke up at 2:18 PM
Actual wake window: 2h15m
Nap: 2h09m (contact napping and crib)
Wake window to test: 2h
Woke up: 2:18 PM
Fell asleep: 4:48 PM
Actual wake window: 2h30m
Nap: 45 minutes
Wake window to test: 1h10m
Woke up: 5:33 PM
Fell asleep: 7:45 PM
Actual wake window: 2h12m
We put her in the crib at 6:45 PM to practice independent sleep when she was almost asleep, and we gave up on the independent sleep attempt at 6:35 PM so that she would not fall asleep overtired.
Nighttime sleep began: 7:45 PM
First stretch of sleep: 3h20m
Number of nighttime awakenings: 4
Woke up for the day: 6:03 AM
Again, thank you very much for your help.
At her age:
1. The longer she naps, the more brainpower she will develop. Never wake her.
2. Night sleep develops around 6 weeks of age but naps around 6 months. Focus on early bedtimes and watch for drowsy signs.
3. Unlatch her gently, put down, leave the room.
4. Not a problem. Shorten the interval of wakefulness before her bedtime.
5. Her bedtime is early (5:30-6:30pm).
Wake windows are not useful; watch your baby, not the clock.
Thank you. I just have one question about your answer to question 3. So should I always unlatch her, put her in the crib, and leave the room, even if that means she might wake up and miss that nap?
Describe the drowsy signs that you observe that tell you when to start soothing her to sleep.
Usually, she gives a little cry as a signal, and her eyes get a little red. Sometimes she yawns, but other times she doesn’t. Sometimes she even seems more alert, and sometimes she has a blank stare. I find it difficult to identify her drowsy signs accurately.
We are on the second night of extinction and tonight I put her in bed at 5:20pm and she cried for 40 minutes and since that was the cap we decided I went in and rocked her to sleep. This is the second night this happens. However tonight she cried harder than last night. Am I making it more difficult by putting a cap? What do you suggest?
Are you using drowsy signs or wake windows?
I don’t use fixed wake windows. I only used them as a general guide to have an idea of when she might be tired, and then I experimented with her to try to figure out the best time to put her to sleep. But I have to admit that I rely more on the clock than on her drowsy signs because I don’t feel that I’m very intuitive when it comes to recognizing when my daughter is sleepy.
The schedule that you shared indicates that the intervals of wakefulness before her naps and bedtimes is way too long. This is the cause of your observations because she develops pre-sleep arousal (“more alert”). Please look at my Blog Posts on Drowsy Signs and shorten the intervals of wakefulness before all her sleep periods to about 90 minutes or less. Then you will see longer naps and more self-soothing behaviors and more drowsy signs. Her bedtime will be much earlier.
How does this sound?
Ok, I will try to start adjusting that today. Thank you!