Make a Bedtime Routine for Sleep Training: What is the Key Strategy?

Based on five reviewed studies, placing baby in the crib while still awake with a bedtime routine is key and effective in training babies to sleep, so that they wake up less often and sleep longer through the night.

One experimental study found that more infants (82%) in an experimental group in which the baby was placed in the crib while still awake with a bedtime routine and a favorite blanket or toy could sleep through the night at 12 weeks compared to 61% in the control group which did not follow this practice.

Another experimental study found that by practicing this approach from 4 months, babies wake up less at 9 months compared to babies of parents who did not practice this approach (waking 2.5 time vs. 3.9 times per week).


Created on November 21 2015 at 08: 00 AM

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Details of Scientific Answers: Click on each bullet to Read References


1: "Behavioral Treatment Of Bedtime Problems And Night Wakings In Infants And Young Children," Sleep, 2006, by P SLEEP. (Citations: 383).

This paper reviews the evidence regarding the effi cacy of behavioral treatments for bedtime problems and night wakings in young children. It is based on a review of 52 treatment studies by a task force appointed by the American Academy of Sleep Medicine to develop practice parameters on behavioral treatments for the clinical management of bedtime problems and night wakings in young children. The fi ndings indicate that behavioral therapies produce reliable and durable changes. Across all studies, 94% report that behavioral interventions were effi cacious, with over 80% of children treated demonstrating clinically significant improvement that was maintained for 3 to 6 months. In particular, empirical evidence from controlled group studies utilizing Sackett criteria for evidence-based treatment provides strong support for unmodifi ed extinction and preventive parent education. In addition, support is provided for graduated extinction, bedtime fading/positive routines, and scheduled awakenings. Additional research is needed to examine delivery methods of treatment, longer-term effi cacy, and the role of pharmacological agents. Furthermore, pediatric sleep researchers are strongly encouraged to develop standardized diagnostic criteria and more objective measures, and to come to a consensus on critical outcome variables.

2: "Nighttime Sleepwake Patterns And Selfsoothing From Birth To One Year Of Age: A Longitudinal Intervention Study," Journal of Child Psychology and Psychiatry, 2002, by MM Burnham, BL GoodlinJones. (Citations: 184).

Background: The objectives of this study were to:(1) describe the longitudinal development of sleep-wake patterns of solitary-sleeping infants from 1 to 12 months of age,(2) identify effects on sleep patterns and on self-soothing behaviors of introducing a novel sleep aid, ...

3: "Reducing Night Waking In Infancy: A Primary Care Intervention," Pediatrics, 1992, by R Adair, B Zuckerman, H Bauchner, B Philipp. (Citations: 112).

Abstract Approximately 25% of infants wake regularly at night and need help in resettling. The purpose of this study was to implement and evaluate a brief intervention to prevent such night waking. The study used a prospective cohort design with historical controls. ...

4: "Use Of A Behavioural Programme In The First 3 Months To Prevent Infant Crying And Sleeping Problems," Journal of paediatrics and child health, 2001, by S JamesRoberts, P Gillham. (Citations: 88).

Objective: To assess the effectiveness of a behavioural programme introduced in the first 3 months of age in preventing infant crying and sleeping problems. Two issues were addressed:(i) which elements of the behavioural programme would parents implement; ...

5: "Preventing Sleeping Problems In Infants Who Are At Risk Of Developing Them," Archives Of Disease In Childhood, 2003, by M Nikolopoulou, I St James-Roberts. (Citations: 48).

Aims:(1) To identify factors at 1 week of age which put infants at risk of failing to sleep through the night at 12 weeks of age.(2) To assess whether a behavioural programme increases the likelihood that these infants will sleep through the night at 12 weeks of age. ...

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