Emily Oster

7 min Read Emily Oster

Emily Oster

Is There a Best Method for Sleep Training?

What about a best age?

Emily Oster

7 min Read

There are few things in parenting more likely to provoke strong feelings than sleep training. Online —especially on Instagram — you can see a huge range of feelings. Depending on who you ask, sleep training is either completely necessary to raise a competent child or a sure-fire way to create an attachment disorder. Most of these claims are not evidence-based. In the data, whether you sleep train your child or not does not drive long-term outcomes.

I’ve written about this extensively before, in Cribsheet and in this ParentData post. There, I focused on the number one question that people ask: Will sleep training damage my baby and ruin our attachment? The answer is no. I discuss an extensive array of randomized trials that follow kids up to early childhood and evaluate both child and parental functioning. Overall, sleep training programs improve infant sleep, lower parental depression, and seem to have no long-term impacts on children.

This post is not about those questions. It is, instead, about the sleep training details. Many people are sold on the idea of sleep training, but then there is the how? When do you start? Is there a better method?

These questions are not answered with large randomized trials, I am sorry to say. You could imagine such a study — recruit people, randomly encourage some to sleep train at three months, some at six, some at nine, and follow their success and their children over time. It’s not that it would be impossible to do it, but a really good study like this would take a long time and be expensive. Funding for such studies in general pediatrics is not great. In addition: based on what we do know, it seems unlikely that there would be any very large differences. This means that either you need a huge sample size or you would find nothing.

In lieu of this, we can ask for a “second best”: at least an understanding of what other people do. Today I will surface some new data on that question. First, from a recent study based on people using a sleep monitor. And second, from a survey I ran of you all. Will this tell you precisely what you should do? No. But it will give a sense of how others are implementing sleep training, and I’ll try to bring it together with some thoughts at the end.

Note: If you are not a parent or a regular reader of this newsletter, “sleep training” as colloquially used refers to using some kind of “cry-it-out” approach to encouraging babies to fall asleep on their own. Researchers tend to call these “behavioral sleep interventions,” or BSIs. For today, we’ll go with “sleep training.”

Quick theory on sleep training

A general piece of advice you can find around the internet is that it’s good to wait until four to six months for sleep training, since that is the age at which babies can better self-soothe (suck on their hands, etc). This may have some theoretical basis, but there isn’t some written-in-stone tablet that says that four months is a magic moment when this will be possible/easier. Plenty of advice suggests earlier (the Tribeca Pediatrics network famously pushes sleep training at eight weeks) and other people say wait (or never do it).

Babies differ in their temperament as well. We had planned to wait to sleep train Finn, but at about 10 weeks it became completely clear that we were making his sleep worse by rocking him to sleep. The first night we left him alone, he cried for much, much less time than he had the previous nights when we were there.

Bottom line: we can’t really use theory alone here.

Nanit study

The Nanit baby monitor is one of the Teslas of baby monitors. It tracks your baby’s sleep, breathing, etc. No, you do not need it. However, the fact that people own these is a great opportunity for the company to do research on sleep.

In November, this team published a paper in the Journal of Pediatrics with findings from one such study.

For the study, they recruited 2,090 parents of children 3-18 months who used a Nanit. The participants completed a survey about infant sleep, their use of sleep training techniques, and their own sleepiness and depression and parent-infant bonding. The researchers collected data from the monitors to try to evaluate infant sleep objectively. [Note: Unsurprisingly, the sample in this study is disproportionately higher-income and white, relative to the U.S. population.]

The most interesting data, to my mind, is in what parents are doing: 64% of parents report some sleep training, and they do it at an average of 5.3 months of age. The authors distinguish between three approaches: “unmodified extinction” (cry it out without checks), “modified extinction” (cry it out with checks), and “parental presence” (cry it out with parents in the room). Modified extinction was the most common approach (43% of people try it), followed by unmodified extinction (28%) and parental presence (10%).

There are three primary results to pull out here.

First: Modified and unmodified extinction work better than parental presence. They take fewer days (as reported by the parents), and the objectively measured sleep is better for these groups of infants. Unmodified extinction looks slightly better than modified, but those differences are not significant.

Second: These approaches can take longer than some people hope. For both extinction approaches, improvement was seen within nine days on average, but with a wide range. For parental presence, the time to improvement was 15 days on average. This doesn’t mean no one was successful in a few days, but it’s not always immediate.

Third: There doesn’t look to be a large difference in success or outcomes depending on when the sleep training is occurring. Earlier or later than the norm doesn’t matter.

This paper also looks at differences in things like parental depression, exhaustion, and their reports of bonding. The researchers see no differences across groups in these outcomes. They read this as positive in the sense of suggesting no impacts on parent-child bond. This seems like a plausible conclusion, but the reality is the data we already have on this is much better.

Bottom-line findings here: The average age of sleep training is 5.3 months (though with a wide range); it seems to work; and either of the extinction methods are better than the parental presence approach.

ParentData survey

As a second source of data, I crowdsourced information on how you all have done sleep training. Here, I specifically asked for people who had done some sleep training. I asked about the age, about the method, and about your perceptions of success. Importantly, I asked here about all kinds of sleep training — encouraging falling asleep at the start of the night, and also sleeping through.

The survey had about 6,400 responses. [I did not ask about demographics, but this sample likely skews in the same way the Nanit sample does.]

The pie chart below shows the share of people reporting sleep training in each range. Roughly 60% of respondents were in the range of four to seven months. A sizable chunk of people (30%) reported sleep training at ages younger than four months, and a slightly smaller share after seven months. There were people who reported sleep training at under four weeks, but this group was very small.

The methods used also echo the Nanit data, as shown in the chart below. Modified extinction is the most commonly used method — at all ages — and parental presence is the least commonly used.

I was especially interested in perceptions of success. Unsurprisingly for a sample of people who reported sleep training, the overall perception of success was extremely high. On a scale from 1 to 10, where 10 is the highest, the average was 8.7 overall. What I found more interesting is that there was almost no variation across age. Those who sleep trained under 16 weeks averaged their perceived success at 8.9, versus 8.7 for those between four and seven months, and 8.5 after. In other words, at all of these ages, success was high and it did not vary much.

Where there are differences in perceived success is across methods. The parents who reported the “parental presence” approach reported only a 7.6 for average success out of 10, versus 8.6 and 8.7 for the modified extinction and extinction methods.

The bottom line here is very similar to that in the Nanit study. Sleep training age is five months on average, though with a wide range, and there is stronger evidence for success from extinction approaches than parental presence. Oh: and noting that the number one recommendation in the comments was the program Taking Cara Babies.

Tying together

It’s not a big, awesome randomized trial, but I think we do learn something here from these two data sets.

First: People sleep train successfully at a wide range of ages. Four to five months is the average, but plenty of people are doing it earlier or later, and generally with similar levels of success. So there is a lot of freedom to choose your own adventure.

Second: The parental presence approach really doesn’t seem to work well. I do not find this surprising, in part because it is very hard to do consistently. Sleep training is a challenge for many parents, and consistency is key to success. It’s hard to avoid responding when you’re in the room. The most successful approach — though differences are small — seems to be the cold-turkey close-the-door, likely due to the same logic: it’s easiest to follow through on.

I also learned something in reading the comments in the ParentData survey. Many people talked about the huge value sleep training brought them: “Sleep training saved my sanity and marriage!”; “Highly recommend sleep training! It was a godsend for us (parents) and our infant at the time”; “I would literally be dead without sleep training.”

But some people said otherwise: “It amped up my PPA/PPD suffering considerably for months after. The message that this works for all babies if you just ‘do it right’ is toxic and implies that if your baby won’t sleep, you have failed”; “I deeply resent everything I read about this during this time, which basically said if it’s not working, it’s because you’re not being consistent and strict enough and are folding to your weak maternal sympathies.”   

This is important to surface. Sleep training can be a great option, but it is not for everyone. Just as people can feel judged for sleep training, they can feel judged for not doing it. Engaging in any parenting behavior because it’s what’s expected of you is not a good idea. If sleep training isn’t for you, then it isn’t for you. Period.

So: Go forward with what works for your family. If that’s sleep training, make a plan and implement it. Hopefully this data is helpful. If it’s not, that’s okay too. Either way, Happy New Year, and happy sleeping.

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Milestones. We celebrate them in pregnancy, in parenting, and they’re a fun thing to celebrate at work too. Just a couple years ago I couldn’t have foreseen what this community would grow into. Today, there are over 400,000 of you here—asking questions, making others feel seen wherever they may be in their journey, and sharing information that supports data > panic. 

It has been a busy summer for the team at ParentData. I’d love to take a moment here to celebrate the 400k milestone. As I’ve said before, it’s more important than ever to put good data in the hands of parents. 

Share this post with a friend who could use a little more data, and a little less parenting overwhelm. 

📷 Me and my oldest, collaborating on “Expecting Better”

Milestones. We celebrate them in pregnancy, in parenting, and they’re a fun thing to celebrate at work too. Just a couple years ago I couldn’t have foreseen what this community would grow into. Today, there are over 400,000 of you here—asking questions, making others feel seen wherever they may be in their journey, and sharing information that supports data > panic.

It has been a busy summer for the team at ParentData. I’d love to take a moment here to celebrate the 400k milestone. As I’ve said before, it’s more important than ever to put good data in the hands of parents.

Share this post with a friend who could use a little more data, and a little less parenting overwhelm.

📷 Me and my oldest, collaborating on “Expecting Better”
...

I spend a lot of time talking people down after they read the latest panic headline. In most cases, these articles create an unnecessary amount of stress around pregnancy and parenting. This is my pro tip for understanding whether the risk presented is something you should really be worrying about.

Comment “link” for an article with other tools to help you navigate risk and uncertainty.

#emilyoster #parentdata #riskmanagement #parentstruggles #parentingstruggles

I spend a lot of time talking people down after they read the latest panic headline. In most cases, these articles create an unnecessary amount of stress around pregnancy and parenting. This is my pro tip for understanding whether the risk presented is something you should really be worrying about.

Comment “link” for an article with other tools to help you navigate risk and uncertainty.

#emilyoster #parentdata #riskmanagement #parentstruggles #parentingstruggles
...

Here’s why I think you don’t have to throw away your baby bottles.

Here’s why I think you don’t have to throw away your baby bottles. ...

Drop your toddlers favorite thing right now in the comments—then grab some popcorn.

Original thread source: Reddit @croc_docs

Drop your toddlers favorite thing right now in the comments—then grab some popcorn.

Original thread source: Reddit @croc_docs
...

Just keep wiping.

Just keep wiping. ...

Dr. Gillian Goddard sums up what she learned from the Hot Flash  S e x  Survey! Here are some key data takeaways:

🌶️ Among respondents, the most common s e x u a l frequency was 1 to 2 times per month, followed closely by 1 to 2 times per week
🌶️ 37% have found their sweet spot and are happy with the frequency of s e x they are having
🌶️ About 64% of respondents were very or somewhat satisfied with the quality of the s e x they are having

Do any of these findings surprise you? Let us know in the comments!

#hotflash #intimacy #midlifepleasure #parentdata #relationships

Dr. Gillian Goddard sums up what she learned from the Hot Flash S e x Survey! Here are some key data takeaways:

🌶️ Among respondents, the most common s e x u a l frequency was 1 to 2 times per month, followed closely by 1 to 2 times per week
🌶️ 37% have found their sweet spot and are happy with the frequency of s e x they are having
🌶️ About 64% of respondents were very or somewhat satisfied with the quality of the s e x they are having

Do any of these findings surprise you? Let us know in the comments!

#hotflash #intimacy #midlifepleasure #parentdata #relationships
...

Should your kid be in a car seat on the plane? The AAP recommends that you put kids under 40 pounds into a car seat on airplanes. However, airlines don’t require car seats.

Here’s what we know from a data standpoint:
✈️ The risk of injury to a child on a plane without a carseat is very small (about 1 in 250,000)
✈️ A JAMA Pediatrics paper estimates about 0.4 child air crash deaths per year might be prevented in the U.S. with car seats 
✈️ Cars are far more dangerous than airplanes! The same JAMA paper suggests that if 5% to 10% of families switched to driving, then we would expect more total deaths as a result of this policy. 

If you want to buy a seat for your lap infant, or bring a car seat for an older child, by all means do so! But the additional protection based on the numbers is extremely small.

#parentdata #emilyoster #flyingwithkids #flyingwithbaby #carseats #carseatsafety

Should your kid be in a car seat on the plane? The AAP recommends that you put kids under 40 pounds into a car seat on airplanes. However, airlines don’t require car seats.

Here’s what we know from a data standpoint:
✈️ The risk of injury to a child on a plane without a carseat is very small (about 1 in 250,000)
✈️ A JAMA Pediatrics paper estimates about 0.4 child air crash deaths per year might be prevented in the U.S. with car seats
✈️ Cars are far more dangerous than airplanes! The same JAMA paper suggests that if 5% to 10% of families switched to driving, then we would expect more total deaths as a result of this policy.

If you want to buy a seat for your lap infant, or bring a car seat for an older child, by all means do so! But the additional protection based on the numbers is extremely small.

#parentdata #emilyoster #flyingwithkids #flyingwithbaby #carseats #carseatsafety
...

SLEEP DATA 💤 PART 2: Let’s talk about naps. Comment “Link” for an article on what we learned about daytime sleep!

The first three months of life are a chaotic combination of irregular napping, many naps, and a few brave or lucky souls who appear to have already arrived at a two-to-three nap schedule. Over the next few months, the naps consolidate to three and then to two. By the 10-to-12-month period, a very large share of kids are napping a consistent two naps per day. Over the period between 12 and 18 months, this shifts toward one nap. And then sometime in the range of 3 to 5 years, naps are dropped. What I think is perhaps most useful about this graph is it gives a lot of color to the average napping ages that we often hear. 

Note: Survey data came from the ParentData audience and users of the Nanit sleep monitor system. Both audiences skew higher-education and higher-income than the average, and mostly have younger children. The final sample is 14,919 children. For more insights on our respondents, read the full article.

SLEEP DATA 💤 PART 2: Let’s talk about naps. Comment “Link” for an article on what we learned about daytime sleep!

The first three months of life are a chaotic combination of irregular napping, many naps, and a few brave or lucky souls who appear to have already arrived at a two-to-three nap schedule. Over the next few months, the naps consolidate to three and then to two. By the 10-to-12-month period, a very large share of kids are napping a consistent two naps per day. Over the period between 12 and 18 months, this shifts toward one nap. And then sometime in the range of 3 to 5 years, naps are dropped. What I think is perhaps most useful about this graph is it gives a lot of color to the average napping ages that we often hear.

Note: Survey data came from the ParentData audience and users of the Nanit sleep monitor system. Both audiences skew higher-education and higher-income than the average, and mostly have younger children. The final sample is 14,919 children. For more insights on our respondents, read the full article.
...

Happy Father’s Day to the Fathers and Father figures in our ParentData community! 

Tag a Dad who this holiday may be tricky for. We’re sending you love. 💛

Happy Father’s Day to the Fathers and Father figures in our ParentData community!

Tag a Dad who this holiday may be tricky for. We’re sending you love. 💛
...

“Whilst googling things like ‘new dad sad’ and ‘why am I crying new dad,’ I came across an article written by a doctor who had trouble connecting with his second child. I read the symptoms and felt an odd sense of relief.” Today we’re bringing back an essay by Kevin Maguire of @newfatherhood about his experience with paternal postpartum depression. We need to demystify these issues in order to change things for the better. Comment “Link” for a DM to read his full essay.

#parentdata #postpartum #postpartumdepression #paternalmentalhealth #newparents #emilyoster

“Whilst googling things like ‘new dad sad’ and ‘why am I crying new dad,’ I came across an article written by a doctor who had trouble connecting with his second child. I read the symptoms and felt an odd sense of relief.” Today we’re bringing back an essay by Kevin Maguire of @newfatherhood about his experience with paternal postpartum depression. We need to demystify these issues in order to change things for the better. Comment “Link” for a DM to read his full essay.

#parentdata #postpartum #postpartumdepression #paternalmentalhealth #newparents #emilyoster
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What does the data say about children who look more like one parent? Do they also inherit more character traits and mannerisms from that parent? Let’s talk about it 🔎

#emilyoster #parentdata #parentingcommunity #lookslikedaddy #lookslikemommy

What does the data say about children who look more like one parent? Do they also inherit more character traits and mannerisms from that parent? Let’s talk about it 🔎

#emilyoster #parentdata #parentingcommunity #lookslikedaddy #lookslikemommy
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SLEEP DATA 💤 We asked you all about your kids’ sleep—and got nearly 15,000 survey responses to better understand kids’ sleep patterns. Comment “Link” for an article that breaks down our findings!

This graph shows sleeping location by age. You’ll notice that for the first three months, most kids are in their own sleeping location in a parent’s room. Then, over the first year, this switches toward their own room. As kids age, sharing a room with a sibling becomes more common. 

Head to the newsletter for more and stay tuned for part two next week on naps! 🌙

#parentdata #emilyoster #childsleep #babysleep #parentingcommunity

SLEEP DATA 💤 We asked you all about your kids’ sleep—and got nearly 15,000 survey responses to better understand kids’ sleep patterns. Comment “Link” for an article that breaks down our findings!

This graph shows sleeping location by age. You’ll notice that for the first three months, most kids are in their own sleeping location in a parent’s room. Then, over the first year, this switches toward their own room. As kids age, sharing a room with a sibling becomes more common.

Head to the newsletter for more and stay tuned for part two next week on naps! 🌙

#parentdata #emilyoster #childsleep #babysleep #parentingcommunity
...

Weekends are good for extra cups of ☕️ and listening to podcasts. I asked our team how they pod—most people said on walks or during chores. What about you?

Comment “Link” to subscribe to ParentData with Emily Oster, joined by some excellent guests.

#parentdata #parentdatapodcast #parentingpodcast #parentingtips #emilyoster

Weekends are good for extra cups of ☕️ and listening to podcasts. I asked our team how they pod—most people said on walks or during chores. What about you?

Comment “Link” to subscribe to ParentData with Emily Oster, joined by some excellent guests.

#parentdata #parentdatapodcast #parentingpodcast #parentingtips #emilyoster
...

Humility. That’s why. That’s the whole reason.

#emilyoster #secondbaby #parentingjokes #parentinghumor

Humility. That’s why. That’s the whole reason.

#emilyoster #secondbaby #parentingjokes #parentinghumor
...

Bug season is upon us. Besides annoyance, this can bring up safety concerns, particularly with ticks. They are carriers of diseases, most notably Lyme disease. So what’s the best course of action?

Prevention is key! I suggest:
⭐ Regular tick checks
⭐ Using bug sprays with DEET 
⭐ Wearing long sleeves and pants in the woods

Some parents worry about DEET, but repellants with up to 30% DEET are recommended by both the CDC and AAP. The data says you’re in the clear, so go for it. Enjoy your summer!

#parentdata #emilyoster #tickseason #bugbites #bugspray

Bug season is upon us. Besides annoyance, this can bring up safety concerns, particularly with ticks. They are carriers of diseases, most notably Lyme disease. So what’s the best course of action?

Prevention is key! I suggest:
⭐ Regular tick checks
⭐ Using bug sprays with DEET
⭐ Wearing long sleeves and pants in the woods

Some parents worry about DEET, but repellants with up to 30% DEET are recommended by both the CDC and AAP. The data says you’re in the clear, so go for it. Enjoy your summer!

#parentdata #emilyoster #tickseason #bugbites #bugspray
...