Sleep training techniques that allegedly teach “self-soothing” don’t work for half the parents who try them: newly published study.

Regular readers of this blog know of my disdain for the term self-soothing when used in the context of “teaching” babies to sleep through the night. They also know that one of my big concerns about sleep training methods that involve leaving babies to cry on their own is the way their proponents (I’m talking about professionals here, not parents) try to push these methods on all parents and imply that “teaching” babies to sleep independently is necessary for their well-being. But what I want to talk about today is another one of the lies about sleep training, which is that it usually works.

Oh, it works sometimes, for some parents, but not nearly as often as some experts imply. Anecdotally I always knew that sleep training wasn’t nearly as successful as the liars make it out to be.  It wasn’t true for my family 29 years ago and lots of other parents have told me they tried sleep training without no success. Or it worked briefly and then their baby got a cold, or started teething, or the family went on holiday and things were back to square one.

These parents feel doubly bad. They feel bad because their baby still wakes up a lot and they now feel even worse because they have “failed” with a technique that experts have told them is effective and necessary for proper development (plus they’ve been fed the lie that nightwaking is abnormal).  What’s more, conventional sleep experts don’t offer these parents any alternative. So they are left to struggle and feel bad about themselves. This is harmful. And if there is one thing those who advise parents should strive not to do it’s make parents feel worse than they already feel. That’s why I’ve always wanted sleep training proponents to support parents who aren’t comfortable with (or can’t/won’t do sleep training) and also to admit that their methods aren’t necessary for optimal child development and, most importantly, that they don’t work for all families.

Actually, even the studies cited to buttress the idea that sleep training is “effective” show quite clearly that it doesn’t always work.  Even in clinical studies, where parents get instruction on how to do controlled-crying, as researchers call it, and support in implementing the technique, the technique doesn’t always work. But researchers tend to downplay this, even sidestep it, in their papers.

What’s more, most parents do sleep training on their own, within the messy realities of their own homes, and their own beliefs and interpretations, without professional support. How well do those parents do? Well. I can tell you that a study that I helped design shows that more than half of them don’t succeed. A paper, that I co-authored, was just published in the Journal of Reproductive and Infant Mental Health. It came out of a study led by Dr. Lynn Loutzenhiser, of the University of Regina. We did an internet survey where we asked parents about their experiences with night waking and sleep training. Had they tried it? How often? For how long? What was it like? Did it work for them?

We surveyed 411 mothers of 6 – 12 month-old babies. Half of them had tried sleep training (which we referred to as controlled crying; parents call it Ferberizing or crying it out). Most likely some of those who didn’t try it never needed to because their babies started sleeping through the night (or at least, going back to sleep on their own) without any particular effort on the part of their parents.

I can’t show you the whole paper for reasons of copyright (the language is pretty academic anyway). However, I can a provide a link to the abstract (synopsis)) and tell you  – in everyday language – what we found.

Let me get right to the most important finding. Controlled crying didn’t work for more than half the parents who tried it.

In fact, only 14% said it eliminated night waking completely, while 24% said it reduced night waking significantly.

However, 42% said sleep training didn’t make any difference at all! Some of them had tried it four or more different times!  Ouch!  That’s a lot of pain for no gain, and a lot of parents who, along with feeling guilty, probably were kicking themselves for not being able to succeed with a technique that they been told was “effective,” and important.

Another interesting finding was that lack of success (or success) with sleep training was related partly to parents’ own beliefs and perceptions. For example, parents who felt that their babies would feel abandoned if left alone to cry, were more likely to report that sleep training didn’t work. Those who rated sleep training as stressful for their child were also less likely to succeed. And, in a really interesting finding that wasn’t reported in this paper (for complicated reasons), parents reported different intensities to their babies’ crying upon awakening. A little over half said their babies weren’t that upset at first, but got more upset as time went on (if the parents didn’t respond right away). That’s the picture that sleep experts usually paint. But some said their babies got to crying hard very quickly. A small, but sizable minority (16%) even said that their babies appeared to be crying hard even before they were really awake (something we experienced with one of our kids). I ask you, how is an infant in that state suppose to “self-soothe?” As you would guess, mothers of intense criers were less likely to get anywhere with sleep training.

So what does this boil down to?

First, sleep training proponents should admit that their methods don’t always work, and that they may not be  (aren’t) the ideal strategy for some families. Second, they should pay attention to parents’ feeling that sleep training is stressful for babies (and themselves). Because that feeling affects both the likelihood of success and also how parents feel about themselves after trying sleep training and failing at it, as our study shows, many of them do. And most importantly, parents who want to try sleep training should go into it with the understanding that it doesn’t work for many parents. So, if it doesn’t work for you, you didn’t fail, the technique failed.

Sleep training proponents should also acknowledge that parents of night-wakers are caught between conflicting sets of advice. On one hand they are told – quite universally – that responding to babies’ distress quickly is important, and to breastfeed on demand. Then on the other hand, they are told to not respond to babies’ distress during sleep training and/or not to nurse this baby who is accustomed to nursing for comfort (as well as nutrition).

It’s quite clear that the sleep trainers have been very successful in making many parents thinks that they should used controlled crying to teach babies to sleep through the night. Or maybe parents just do it because they want a good night’s sleep and this is the technique that they’ve heard about.

But please, don’t just tell parents that sleep training “works.” Because outside of the unreal world of clinical studies, it doesn’t work very well for most people. In fact, I’m convinced that there are some babies (and parents) for whom it will most likely never work. Thus, parents should be supported to live and cope with night-waking if they want, or co-sleep or do whatever else they need to get through the night and get enough rest. That would be a lot more productive than making parents feel like failures and insisting that they try a technique that has a spotty record of success.

Note added July 28, 2014. For another take our research findings by a very knowledgeable blogger check out Evolutionary Parenting.

About uncommonjohn

I am one of Canada's top parenting writers. My areas of expertise and interest include debunking bad parenting advice (especially about sleep), self-regulation, fatherhood, child development, children's mental health, childbirth and breastfeeding.
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13 Responses to Sleep training techniques that allegedly teach “self-soothing” don’t work for half the parents who try them: newly published study.

  1. Kristen says:

    THANK you! Every parent struggling with night wakings should read this!

  2. Rachel says:

    I just want to say how much I like your blog. I stumbled across it during a night feeding last night and I wish I had found it earlier. I’m a pediatrician (I don’t practice general pediatrics, though, I’m in training to specialize), and I have a 2 month old. Early on I was not sleeping well and was occasionally bed sharing just to cope, despite wanting to do all the “right” things per the AAP that I had learned during pediatric training. I looked at all sorts of information including the AAP sleep policy statement and couldn’t find what I wanted, which were the basic facts, not couched in agenda, the type of information that I use in my work to decide about antibiotic regimens and vaccines. That information is hard to find when it comes to parenting topics – it’s as if the AAP and other organizations have decided that parents aren’t capable of making informed decisions when presented with options and information, so they adopt a “better safe than sorry” blanket approach to everything. It’s so refreshing to see someone break through the propaganda aspect. If you’re looking for topics of interest, one thing I would like to see more about is “tummy time,” this idea of having babies play on their stomachs to develop head control and upper body tone since we are all now advised to have them sleep supine. My daughter hates being placed directly on her stomach, unless she’s on me. If I put her down anywhere else, even propped up a little, she fusses until I turn her over. She’s not practicing any developmental skills during this time. The thing is, despite this, she has great head control and upper body tone, and pushes up a lot to see over my shoulder when carried. I question the advice to push her into an activity that she clearly dislikes (as I’ve heard many babies do) if there’s no evidence that it actually improves motor development, she doesn’t use that time to practice the skill that it’s supposed to help her learn, and she’s developing the skill through other means. Yet there is so much emphasis on tummy time – special mats marketed for it, articles on how to make it palatable to babies, and so on. Along with this there is the hype about positional plagiocephaly (flat head), the use of helmets, and the recent study showing that helmets do not actually work to reshape flat heads. It could be an interesting topic to explore further.

    • uncommonjohn says:

      Hi Rachel: Thanks so much for your comments. They are very affirming coming from a pediatrician. Suffice to say that I think you are bang on with everything you say, particularly the safe but sorry doctrine, which, in my view is well-intentioned but poorly thought out. I think the intent is to cause no harm, but I believe that some of the safe but sorry advice causes considerable harm, primarily in terms of distress to parents who feel pulled to follow their evolutionary instincts but keep being told that those instincts are wrong. I’ve even spoken to a SIDS researchers who wonders if the rise of infant deaths related to sofa sharing may have been partly caused by parents trying to avoid bedsharing.
      I’ve always thought that tummy time was a bit of a crock too. And I was amazed at how quickly tummy time became a universal given in North America. The real issue here, I suspect, is not babies sleeping on their backs, but that many of them spend too much time in “containers” – car seats, baby chairs, lying in strollers etc. I suspect that if we could get more babies having more time in arms or in carriers, we see much less flat-head syndrome. I have also heard nurses say that tummy time develops neck muscles that could save a baby from suffocation, but I’ve seen no proof of that. I’m always amazed by the lack of evidence behind some public health (and, in some cases) medical practices. Another niche issue that interests me is testing one or two day-old babies’ blood glucose level in hospital to assess their “nutritional status.” I have no idea how widespread this is, but I’ve been hearing about it and it appears to be one of the many entrenched hospital practices that likely interferes with breastfeeding. From what I’ve read, there is not a sufficient knowledge base on normative baseline newborn BG levels to allow anyone to really understand what the BG numbers mean.

    • Heather says:

      Tummy time is an interesting one. My baby has always preferred it on her tummy so gets a lot of tummy time. She even sleeps on her tummy. (Much to my health visitors disgust) but it is the only way she will sleep. Put her on her back and she screams straight away, then my husband decided to put her on her tummy and she slept for he first time without being on my chest. She has had very good neck control and has been doing push ups from a very early age but I don’t know if this has anything to do with being in her tummy. I do think it is important for them to spend time both on their tummy and back. To practice things like rolling over, and push ups and learning to crawl. Rather than spending so much time being held or in bouncers etc…. I know an 18month old that doesn’t walk or crawl due to the fact she is carried everywhere and always held. She has no need to do any of these things.

  3. Nicky says:

    I love this blog. Even though my 3 children are all way past the night-waking/breastfeeding stage, it is so refreshing to read your advice, which I feel is much more instinctive and natural for most parents. I personally never tried ‘controlled crying’ as it didn’t feel right for me, but I can see how tired, vulnerable new parents could be encouraged to try this, especially without a support network around them. My children were all night wakers as babies, but co-sleeping allowed me to wake up, breastfeed, and go straight back to sleep. I think I would have got less sleep if I had tried something that would have given me a lot of guilt, and which probably wouldn’t have worked anyway. That period of night-waking is over before you know it (although it might not seem it at the time!) and I think rather than treat it as if it’s something you’ll never be rid of, and that must be solved at all costs, parents should be encouraged and reminded that ‘This too shall pass’
    Another thing I love about your posts is that you are giving facts and evidence, not just opinions (as to whether you agree with something or not) I think this is very valuable for new parents. There are probably plenty of sites where they can read about the emotional aspects of these issues (whether attachment parenting websites or mainstream ones) but yours is one of the few I’ve seen which actually gives scientific evidence in favour of a more natural, instinctive approach. Brilliant!

  4. uncommonjohn says:

    Gee. Thanks Nicky! Best wishes with your parenting journey.

  5. Annie says:

    Thank you for this. Sleep training didn’t really work for us. My 6 mo can now put himself to sleep (although one night with a babysitter putting him to sleep on a bottle threw it off and he cried the next night) but 6 weeks after we started, he still wakes up and has a hard time falling back asleep — no crying but lots of moaning. And even on good nights he never sleeps the 11-12 hours the experts claim is necessary. It actually did work well for naps which were more of a problem to me than his night sleep. Everyone insists sleep training is a miracle but I’m slowly meeting more parents who also felt that it didn’t really work. And now I’m even more reluctant to go on vacation or let someone else put him to bed out of fear that we will have to do it all over again if he is put down asleep for one night.

  6. Mamaduck says:

    The timing is perfect. Struggling with sleep deprivation and although I wouldn’t even consider sleep training after reading a previous post of yours, the extra validation/affirmation that it might not even work just serves to strengthen my resolve. Love your work.

  7. Jen says:

    Thank you for this blog! I suffered from alot of sleep/nightmare/abandonment/trust issues all through my childhood and vowed to be at least an empathetic mother since perfect is impossible. I never thought of bedsharing but would not tolerate “crying it out in any way.” For the first 4 months, my husband who is a night owl responded to my baby waking up and would give him a bottle to give me more rest. I was miserable because I had to pump and his cries woke me up anyway. At 4 months he started refusing my husband/bottle and I noticed a change in his cry. He started sounding terrified. I took over, but getting him to settle in his crib was a nightmare. I tried a cot next to my bed. He would wake every 45 minutes crying. I was a wreck after a few weeks and started cosleeping despite zero support from anyone. They all told me to try sleep training but I could not imagine ignoring his terrified cries. It literally made my heart race. I researched online and yours is one of the sources I used to get then off my back ( though they can’t really be bothers to read/learn why I made my decision) anyway my baby is now turning a year old and still wakes and nurses several times a night. Despite only getting 5 hours of broken sleep I feel more rested than ever. He’s a confident and happy baby so the naysayers generally shut up about it now. Best thing was when we went to my grandmothers funeral and he was forced to car ride a total of 35 hours and sleep on the floor with me in hotels for 4 nights and was seldom fussy and delightful at the funeral.

    • Jen says:

      Ps he hated tummy time too and I didn’t do much as a result. I was worried that he didnt roll much until 7 months but shortly after he crawled, stood up and walked on his own by 9 months.

  8. Emma says:

    I am going to bookmark this page to re-read every time some well meaning relative tells me I just need to leave my baby to cry and she needs to be in her own room and sleeping through the night. I am a FTM to a gorgeous, happy, joyful 5 month old who I am always being told is the happiest baby who never cries and who has turned all my parenting pre-conceptions on their head. I co-sleep because it is what she needs, I never even entertained the idea before she was born. I know in my heart sleep training would never work on her she is too intense, too sensitive, too strong willed for heavy handed techniques to get her to sleep on her own and sleep all night. When I am tired and doubting myself I will revisit this and some of your other great articles to remind myself I know my baby best!

  9. C says:

    I know this is old, but I’m confused. You wrote a journal article based on an internet survery with 411 respondents? this hardly seems scientific.

    • uncommonjohn says:

      Fair question. I was only a third co-author on the stud (although I did help to design the survey and write the paper). The principal author was a professor of psychology at the University of Regina and the study, and the survey, was designed in a way that met academic standards for that type of study. Obviously there are scientific limitations on a study like that because the sample is self-selected and cannot be taken as any sort of representative cross-section of society, which we reported in our two published papers. A number of researchers are doing studies of this type these days (they call the sample a convenience sample). It’s one accepted form of research, but not necessarily the ideal form because of the limitation I mentioned earlier. I’ve seen lots of other published studies (not internet studies, but studies of an intervention or treatment) where there is a very small sample size – like 6- 10 people. Those have limitations as well, but even those studies sometimes also provide useful information.

      The advantage of the convenience sample approach is that you can gather data quickly and inexpensively, with a relatively large sample, and gain information that may point to directions for further studies. We also did in-depth interviews with a sub-sample of 30 internet respondents. Unfortunately, none of that data has been analyzed yet, mainly because of lack of funding. I’d also point out that our papers were published in two different peer-reviewed journals (and I might add, some of the peer reviewers were clearly from the sleep-training camp and so were not friendly to either the questions we were asking, nor the findings. So we had to go through the wringer to ensure that we met the journal’s standards, which we did or the papers wouldn’t have been published.

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