Sleep training might be one of the most debated topics in parenting but it doesn’t have to be so polarizing. In this Follow-Up episode, I revisit my most downloaded episode, “We’re Losing Sleep Over Our Kids’ Sleep,” to talk honestly about what sleep training really means, the methods that exist, and how to decide what’s right for your family.

You’ll learn:

✔️ What “sleep training” actually means (hint: it’s not one-size-fits-all)
✔️ The differences between the cry-it-out, Ferber, and gradual methods
✔️ Why crying doesn’t mean cruelty—and how boundaries are loving
✔️ How to spot when a method isn’t working for your baby
✔️ Why our generation’s obsession with baby sleep may be adding more stress than it solves

Want more? Listen to the ⁠original full episode⁠.

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00;00;00;02 – 00;00;23;17

Dr. Mona

Welcome to the follow up. I’m Doctor Mona, one of your favorite online pediatricians. Podcast host and mom friend. And this is where we revisit some of your favorite podcast episodes of the PedsDocTalk podcast. In less time than it takes to go down a sleep training is harmful. Rabbit hole online. Lately, I’ve seen a lot of confusion online about baby sleep, especially around sleep training.

 

00;00;23;23 – 00;00;48;09

Dr. Mona

Some say it’s required. Others say it’s harmful. Both lack nuance. Sleep training simply means helping a baby or toddler learn how to fall asleep independently. Now some babies do it on their own naturally, and that’s awesome. And some aided with their parents with check ins or various methods called sleep training can learn to independently sleep. It’s not one size fits all, and it’s not required, but it’s also not cruel.

 

00;00;48;16 – 00;01;18;18

Dr. Mona

And I often hear the it’s cruel side a lot online. And it got me thinking when I originally aired this episode five years ago. The truth is, most of our parents didn’t overthink this stuff. They just let us sleep. They will not talk to you about sleep training because it’s something that didn’t really exist. And while every child’s timeline is different, I do believe that independent sleep can really help the entire family, and it’s possible to either teach the child through sleep training or avoid making some mistakes that can inadvertently keep your kid awake.

 

00;01;18;24 – 00;01;41;18

Dr. Mona

So today we’re revisiting one of my favorite episodes and my most downloaded episode. We’re losing sleep over our kids sleep to share my honest take on sleep training. For anyone new, here are just curious where I stand. My perspective comes from years of clinical experience and child development knowledge, but also from reflection on our culture. As a pediatrician who’s cared for thousands of children over the last decade, I understand the research.

 

00;01;41;20 – 00;01;53;07

Dr. Mona

But I’ve also seen how our generation’s obsession with baby sleep might be creating more stress and guilt than good. Remember to download this episode and the full episode available in the link in bio.

 

00;01;53;14 – 00;01;53;28

Dr. Mona

And if you.

 

00;01;53;28 – 00;02;05;07

Dr. Mona

Enjoyed it, share it to your Instagram and tag at the PedsDocTalk podcast and at PedDocTalk. Let’s get into it.

 

00;02;05;09 – 00;02;25;27

Dr. Mona

It is my belief that all children can be sleep trained, but not in the same method and not at the same time. Okay, so please be clear on that. So when parents, when you hear someone say, oh, your four month olds not sleeping through the night, I don’t want you to feel bad because some kids can’t get that training down at that age.

 

00;02;25;28 – 00;02;45;19

Dr. Mona

Some kids do. So when you listen to the different methods, you’re going to have to kind of look at, okay, what is my child doing? What’s their temperament? Do I feel comfortable with this method? But understand that every child can be sleep trained by the age of one. But not every one of them can be sleep trained in the same method or at the same time.

 

00;02;45;19 – 00;03;08;25

Dr. Mona

Okay. So please remember that when you’re feeling bad or good about what’s going on here. So I am talking about the cry methods first. And then I’m going to go into methods that involve less crying. I don’t like using the word gentle. I mistakenly use that word a lot, especially in the episode with other mothers gentler, meaning less crying because using cry methods is still a gentle, loving way of being a mother.

 

00;03;08;25 – 00;03;27;05

Dr. Mona

I used to cry method, and for any of you following my Instagram, I’m a very loving mother. Ryan loves me and my husband a lot. So I don’t want you to think that a crying method is a form of a non gentle method, if that makes sense. Because it’s not, it’s perfectly fine. So I like to I’m going to use for the sake of this conversation.

 

00;03;27;05 – 00;03;46;19

Dr. Mona

I’m going to use a cry method less cry okay cry and less cry or cry and gradual okay. So the first method is a complete cry it out. And this method is the most controversial method for most people on social media. But I need to explain this method because it is a method that may work for your child and I.

 

00;03;46;19 – 00;04;06;20

Dr. Mona

Again, my job is to give you the information. Your job is to figure out what works best for you and your family and your child. So the complete cried out is a method where you do your bedtime routine. And please remember, you’re always going to be doing a bedtime routine. You’re giving them all the cuddles. You’re giving them everything, and you put them to sleep in their crib on their back.

 

00;04;06;20 – 00;04;28;03

Dr. Mona

Safe sleep protocol and you give them a kiss goodnight. You obviously, you know, can rub their chest. And then you walk out the door and you don’t intervene for 10 to 12 hours. This is a complete quiet out. This actually, this actually is a method that I’ve seen work. This is actually the method we did for Ryan. And it’s a method that I just figured was comfortable for us because I knew Ryan’s temperament.

 

00;04;28;03 – 00;04;50;01

Dr. Mona

He wasn’t waking up a lot in the middle of the night. He was already stretching feedings. He is a pretty chill baby, so I chose this method for us. So this method may work for you. If you have a child who is already showing signs of being a self settler, right? Who is stretching their, you know, feedings already, this may be the method that works best for you.

 

00;04;50;04 – 00;05;09;24

Dr. Mona

The reason I’m bringing this method up is that some babies just do not respond well to Ferber, some that babies do not respond well to the gradual weaning. So some babies need this method. They are a little more independent in nature. So if you’re around and doing graduate extinction like a Ferber method, which I’ll get into, they may not take to it.

 

00;05;09;24 – 00;05;25;11

Dr. Mona

So I’m speaking about this because I think it’s important that it’s in the back of your mind. If it’s not the method you choose first 100% agree with you, that’s fine. But think about it, because if something’s not working, I want you to have all the methods so that you know what may work for you. Now, how much crying is too long?

 

00;05;25;14 – 00;05;45;22

Dr. Mona

That is truly up to you. Okay, I, I I’m not going to give numbers. I’m sure you’ve heard horror stories of like two hours. Three hours. I will say that if a kid is crying more and again, this is arbitrary number. If your child is crying more than an hour and 15 minutes, hour and a half, we may be getting into it being too long, but it’s not too long to cause scarring of any kind.

 

00;05;45;22 – 00;06;01;28

Dr. Mona

The child’s going to be fine, but it just may be too long. That may be this method may not be the one for them, right? This is arbitrary numbers. There’s no data to support how much crying is okay, but how? I know that the crying is okay is because I’ve seen the crying happen, and I’ve seen these kids grow up to be fine.

 

00;06;01;28 – 00;06;18;29

Dr. Mona

And none of us are sitting around as 2030 year old talking about how our parents sleep trained us. We don’t even remember or know if they used a crying method or not. It really has to do, you know, with the whole picture of things, right? So when there’s anti-Christ sentiment, I get a little, you know, like, oh man, what, what are we talking about here?

 

00;06;19;05 – 00;06;38;04

Dr. Mona

Because it’s a multitude of how we love our children, right? Doing sleep training and doing a crime method is a loving parent, right? You are creating a boundary. You’re allowing them this sort of ability to self-soothe, right? So it’s not a negative thing. It’s something that we are giving them a chance to do and they are capable of doing it.

 

00;06;38;04 – 00;07;00;11

Dr. Mona

So the next one is the more common method that I usually talk about. Okay. And this is the method that is the Ferber method. And I’m sure you’ve heard about this. It’s a method that’s graduated extinction which you’re increasing the minutes of time before you go in. So this is the one I usually recommend because most families may not be comfortable with the complete cry it out, even though again, it’s not harmful in my opinion.

 

00;07;00;14 – 00;07;19;14

Dr. Mona

But I would encourage you to maybe think about this one. This one is the research studies out of Australia, that came out. This is the biggest research study for extinct graduate extinction sleep training. Talked about the Ferber type training. Okay. So this is the one that of all the research we know that is researched to show that it is fine and has good outcomes.

 

00;07;19;14 – 00;07;37;06

Dr. Mona

Right. Obviously the complete cried out there’s no research outcomes. I am just personally going by experience and what I see. So I have to be I have to put a huge disclaimer on that. But again, you’re going to choose what’s best for you. So with this one, you are still putting them down. And remember the timing is 7 to 7, 10 to 12 hours.

 

00;07;37;06 – 00;07;55;06

Dr. Mona

But I would do 7 to 7. Same thing with the method prior. So you put them down in their crib. They talk a lot about this drowsy but awake. If you can get them to that point, that’s great. But it really is okay to start it from the time if they’re not completely drowsy because they may not get drowsy till ten.

 

00;07;55;06 – 00;08;14;21

Dr. Mona

If you’re trying to do sleep training, does that make sense? So you’re training them with the timing phase. So you put them down at seven. The when they start crying with Ferber, you start to time it on your watch. And please remember that when your baby’s crying, five minutes can seem like three hours. So you leave the room right after you do a whole lovely bedtime routine.

 

00;08;14;23 – 00;08;30;07

Dr. Mona

You read to them, cuddle with them, put them down, pat their chest. This is what we do every night. And then we walk. You know, you walk out the door when he. When baby cries, you let them cry for five minutes and time it. Okay. You walk into the room, you you just talk to them. You don’t pick them up.

 

00;08;30;07 – 00;08;51;21

Dr. Mona

You do. You can. You know, you don’t play with them. You don’t do anything. You don’t feed them with Ferber. And you basically just talk for a minute. Once that minute is over, you leave the room again, right? Do you let them cry for seven minutes right after? If they still are crying after seven minutes, you go back in one minute of consoling in terms of talking, right?

 

00;08;51;23 – 00;09;08;14

Dr. Mona

The next time they cry, nine minutes. Right? So you’re increasing the amount of crying before you physically go back in. So you will eventually reach a point where you’re not going to be going up on that time because I’ll finally fall asleep. So this is a method that I really like. You know, it’s again my preferred method.

 

00;09;08;14 – 00;09;26;29

Dr. Mona

It’s the method, my go to method. The other cried out method is if a family is like, look, what do you think? Can I do it? Then I say, okay, well, here’s what you have to think about. But this is a method that a lot of you’re gonna hear a lot of pediatricians talk about. Night number two, you basically can start where at the minute you left off.

 

00;09;26;29 – 00;09;45;18

Dr. Mona

So usually what I recommend is do you know five, you see sort of five, five, seven, nine, 11. Right. The increments can be whatever you choose. Honestly, Ferber has its own, but you can do five minute increments. You can do ten minutes. So let’s use for an example, five, ten, 15, 20 minutes. So you can do that.

 

00;09;45;21 – 00;09;59;10

Dr. Mona

Night number two, you start at the next level. So just say night number one, you start at five minutes. Night number two, you start at 10 minutes or 7 minutes. Whatever increments you wanted to choose. And so and then you go up from there and then you’re going to find that this one can also take 3 to 4 days.

 

00;09;59;10 – 00;10;20;03

Dr. Mona

Some kids it can take a little longer. I find and don’t feel disappointed if it does take a little bit longer. My usual advice is if one method you choose is taking longer than two weeks, it’s time to reevaluate and think. Maybe this is not working. Maybe we need to delay it because the baby’s not ready. Or maybe we need to try another method, okay?

 

00;10;20;03 – 00;10;43;11

Dr. Mona

Because like I said, it’s really hard. You may never know what the best timing is. And when the best, method is for your baby and you have to choose what feels best for you. So now I’m going to go over some gradual methods and what I mean by gradual methods is this the Ferber and the cried out that I mentioned, you’re basically not doing anything right besides consoling in the Ferber and the other cried out, you’re not doing anything.

 

00;10;43;16 – 00;11;02;17

Dr. Mona

So if they’re pacifier falls out, you’re not doing anything. If they’re you’re not weaning feedings, you’re not doing any of that. Right. That is one camp of sleep training I’m teaching you guys now about the other of training, because the purpose of this episode is to educate you on the all the options that I see, right. Please decide what works best for you.

 

00;11;02;17 – 00;11;23;02

Dr. Mona

But I’m going to be talking about gradually reducing associations of someone who may be used to the pacifier, Cutler’s nursing feedings, things like this. Right. So these are more gradual methods, and the gradual methods may involve some crying. Again they may. You’re not going to leave them as long as you would with other methods that involve that I mentioned earlier.

 

00;11;23;07 – 00;11;43;04

Dr. Mona

But these are methods that I want you guys to think about. If you would prefer a more gradual method, what do we mean by disassociation? So if your baby wakes up in the middle of the night and was used to you rocking them to sleep, right, that’s the only way that they fall asleep and in the middle of the night they wake up and they’re in a crib and they don’t know where they are.

 

00;11;43;06 – 00;12;02;24

Dr. Mona

They may be used to you rocking them to sleep, to put them back down. If you fed them right before they go to bed, and then they wake up in the middle of the night in the crib, they may need that feeding to go back down. Right. So what we mean by sleep associations is that they have created an association with this is the object, or this is the activity that’s going to make me go to sleep.

 

00;12;02;26 – 00;12;21;11

Dr. Mona

And again, this is not a negative thing. But at some point we want to break that habit so that they can learn to self settle on their own. Is the opinion right. So how does this look like? You decide when you want to reduce the associations, right? Or remove that. And remember like I said, it’s a choice of when you do it and how you do it.

 

00;12;21;14 – 00;12;44;16

Dr. Mona

So if you do the other methods or the other methods, you’re not doing anything with this, right? You’re literally just in a way, cold turkey removing any sort of association. You can always blend a lot of these methods if you like. So if you choose not to do a Ferber method, which basically is no intervention of any kind, you are just doing, you know, comforting graduated intervals with the pacifier.

 

00;12;44;16 – 00;13;01;15

Dr. Mona

So if you want to kind of slowly disassociate the pacifier, right. They’re used to the pacifier and they won’t go down without it. I want you to first try letting them go down with it in their mouth, which is what you guys are normally doing. If you do, it comes out and don’t insert it right away, right? Monitor it.

 

00;13;01;15 – 00;13;21;29

Dr. Mona

See how much time you’re willing to kind of give them. I would encourage you to give five minutes because you may be surprised. I think a lot of the message with sleep in regards to kids is that they can surprise you. We think that, oh, they can’t do it. I need to be there. And then you let them cry for a little bit and then they surprise you and you’re like, whoa, okay, how that happened.

 

00;13;22;01 – 00;13;43;20

Dr. Mona

So give them five minutes or whatever comfortable time period. You know, you are okay with, but definitely give them a moment. And that’s kind of allowing them a little bit of fuss. So option two would be you have them in with the pacifier. You you put them down. They’re super drowsy. Right. And let them get really, really, really drowsy with the pacifier and almost to the point where they’re falling asleep.

 

00;13;43;23 – 00;14;05;04

Dr. Mona

And then when you lay them down, you remove the pacifier when they’re in their crib. Right. Because and when they’re in the crib, what you’re going to see is that they they’re now recognizing that, okay, this is my sleep space. You remove the pacifier and you’re kind of almost reaffirming that you’re in your sleep space. You don’t have the pacifier and you’re going to be okay.

 

00;14;05;07 – 00;14;23;02

Dr. Mona

You may need to allow a little bit of time as well for this method. Right? Meaning a little bit of fussing if they do fuss. But you’re essentially, again trying to reduce the association with the pacifier, right? This method is an option. Like I said, if you want to gradually reduce that pacifier association, you can do the Ferber.

 

00;14;23;02 – 00;14;39;06

Dr. Mona

You can do full cried out if you’d like. But it’s up to you what you feel comfortable with, right? Again, the message of this episode is that whatever you choose, your child is going to turn out fine. Okay? Regardless of what you may hear, I firmly stand behind that, and I wouldn’t support any of the methods I mentioned.

 

00;14;39;08 – 00;14;56;06

Dr. Mona

If that if they weren’t, if they weren’t good for babies and raised amazing children. Okay, so now if you have a cuddler, right? And for Cutler’s most babies are cuddler, right? Some like to cuddle more. Some have gotten way used to the cuddling. So then when now you take it away, they’re like, what the heck is going on?

 

00;14;56;06 – 00;15;15;10

Dr. Mona

Right? But let’s be clear all loving parents want to cuddle their kids, and some children really, really feel like they’ve created the association with it and need it. Some kids are a little more independent in nature and may be fine without it, right? So the first thing when I mean by cuddles is someone who’s used to sleeping on mom for overnight, right?

 

00;15;15;16 – 00;15;33;07

Dr. Mona

And now it’s time to, you know, have them learn to sleep on their own because what’s happening is if they’re used to being rocked down by you, and then all of a sudden you’re not there to do the complete rock down and fall asleep on you. And they’re in a crib. When they wake up throughout the night, they’re going to feel like they need the rocking to go back down.

 

00;15;33;07 – 00;15;55;19

Dr. Mona

Right. So an example of this that you could do toddlers, if you think about it, they are just used to that closeness. Right. And so now we’re trying to gradually get them down where they don’t they don’t physically need the closeness anymore like the physical closeness. So you can switch to a swaddle if they’re younger. If you, if they’re older and they’re rolling over the swaddle cannot be, you know, enclosed on their arms.

 

00;15;55;19 – 00;16;09;27

Dr. Mona

It has to be allowing their arms to be free. You can use sleep sacks or, you can just not do any of that and just use your hand. So if you do a swaddle, an example would be putting them in a swaddle now and you can rock them still, but you put them, you wrap them up in the swaddle and put them down.

 

00;16;10;05 – 00;16;24;24

Dr. Mona

You can put your hand on their chest because again, that’s the physical touch that they just got really used to in order to go back down. So you can put their hand, you can put the hand on their chest and just gently kind of stroke it. Right. Stroke their stroke their chest and you’re basically there for them.

 

00;16;24;24 – 00;16;42;26

Dr. Mona

And you can do that for as long as you feel like you want to. So you pat them, and every time they’re sleeping and every time you do this, you’re reducing the time that you are spending patting them. So just say you’re starting with 20 minutes of padding. The next time they cry, you know, you’re putting them down.

 

00;16;42;26 – 00;17;05;13

Dr. Mona

You pat them for ten minutes. So you’re kind of reducing in increments that you feel fit, so that you can get them kind of down with less and less time. It’s really up to you what sort of rocking you want. So this is a little different than Ferber. The, the removing dissociation of the, you know, reducing time because with Ferber you let them cry and then you go in and then, you know, you talk to them and you increase the amount that they cry.

 

00;17;05;19 – 00;17;25;03

Dr. Mona

In this method, you’re basically standing with them for 20 minutes, even, you know, hand on the chest until they kind of fall asleep, right. If max 20 minutes. And then the next time you do max ten minutes. So you’re actually there from the beginning, rather than leaving the room waiting for them to cry. So this may involve less crying, if that makes sense.

 

00;17;25;03 – 00;17;48;06

Dr. Mona

Right? And with this, you can also move away from the baby, right? So initially you’re kind of next to their bed. You’re patting them the next night. You do less patting than, you know, a few nights later. Once you once you’ve done well with that, then you move away from the crib, right? And you’re just sitting there because again, your presence, if your presence is what they need, you do that for a few nights.

 

00;17;48;08 – 00;18;07;06

Dr. Mona

Lay on the floor next time, whatever you’d like, and then the next few nights you do next to the door, and then the next few nights you move out of the room again. It’s a gradual removal of your physical presence in a way that you, feel comfortable doing right. The you want to basically, you’re getting to the point where you can be present but not engaging, right?

 

00;18;07;06 – 00;18;22;07

Dr. Mona

So like I said, you’re just almost sitting there and just waiting for them. This can take a long time, as you can imagine. I wanted to talk about this method again because I think it’s important you hear about all the methods, because if this method is the one you choose, I really want you to be systematic of how you do it.

 

00;18;22;09 – 00;18;29;19

Dr. Mona

And if it doesn’t work for you, think about the other options right?

 

00;18;29;21 – 00;18;51;01

Dr. Mona

And that’s your follow up. Just a small dose of the real relatable and eye opening conversations we love to have here. If you smiled, nodded, or had an moment, go ahead and download, follow and share this episode with a friend. Let’s grow this village together for more everyday parenting wins and real talk. Hang out with us on Instagram at the PedsDocTalk podcast.

 

00;18;51;08 – 00;18;58;13

Dr. Mona

Want more? Dive into the full episode and more at PedsDocTalk.com. Because parenting is better with support.

 

00;18;58;15 – 00;19;02;15

Dr. Mona

And remember, consistency is key. Humor is medicine and.

 

00;19;02;15 – 00;19;06;22

Dr. Mona

Follow ups are everything. I’m Doctor Mona. See you next time for your next dose.