Ferberize Your Baby And Sleep

The Saturday Early Show asked for feedback and got a flood of emails about correspondent Sandra Hughes' report about a pair of Los Angeles women who are in the business of getting babies to sleep through the night.

Jill Spivak and Jennifer Waldberger call themselves sleep trainers and they make house calls. Click here for the full report.

Viewers were divided about that method. So one of the leading pediatric sleep experts, Dr. Richard Ferber, author of "Solve Your Child's Sleep Problems," addresses some of our viewers' concerns.

Ferber's philosophy is to figure out what is wrong and what needs to be done to correct the problem. And he advises parents to make changes that meet the baby's needs.

He explains, "If the baby is fed too many times during the night, the baby will keep waking up because of expectations of feeding.

"If the baby has pain, the parent will need to treat the pain.

"If the baby cannot sleep on the right schedule, the schedule will need to be adjusted.

"If the baby is scared, then the parent needs to treat anxiety.

"If the baby falls asleep when rocked at bedtime, then the baby needs to fall asleep without being rocked."

Here are the most common reason why babies have trouble sleeping through the night:

• Inappropriate associations with falling asleep
  
• Inappropriate sleep schedule
  
• Too much feeding at night
  
• Limit setting problems (i.e.: "I want to watch TV")
  
• Fears at night
  
• Sickness

He says, "Put the baby in a place where they are going to sleep and have them enjoy an activity. Do not go to the parent's room for a story and then move the baby to their room. This should happen close to the same time every night because a regular schedule is important."

Here are some suggestions to create a good bedtime routine:

• The baby should be on an appropriate sleep schedule for their age.
• The baby should fall asleep under the same circumstances that they wake up to; things should not change. The baby should not fall asleep in the living room and wake up in the crib.
• Don't let your baby associate television with sleep. The baby should not go to sleep with it on, or turn it on as the first activity after waking up.
• Quiet and a relatively dark environment are best for sleep. No bright lights!

When the baby wakes up, he will find that something is missing and the baby will try to get it back. If he falls asleep being rocked and he is not being rocked when he wakes up, it is a sudden change and the baby will get upset.

Ferber, however, stresses the importance of not applying his method blindly.

He says, "Circumstances are not always the same. When the baby cries, if he or she has a scary dream and wakes up frightened, (the baby) will respond differently than when asking for the fifth glass of water. Figure out what is happening and why. You cannot jump right into treatment."

He notes, for example, if a baby is frightened, it is not good for the parent to let the baby cry and leave the room. What the baby needs is reassurance. Or if the babies are crying because they are in pain or they are sick, do not leave them on their own; they need assistance.

Also, he points out that problems take different amounts of time to fix. "A schedule can be changed quickly. If the baby is overfed at night, gradually decrease that overnight," he says. "A baby who is frightened must move in small steps."

If the baby likes to be rocked at night, this can be fixed in one step and that is the easiest: cut out the rocking but still have the parent in the room. Then cut out the parent.

Ferber notes that his method will fix habits, but not schedules and fears, and points out that it only works if the parents are willing to let their babies cry.

"There is no point in having a method you cannot do," he says.

As for the proper time to begin implementing his method, he says, "By three months, habits are falling into place. Babies start to sleep through the night and should not wake up multiple times. If you are not moving in that direction, you should start to figure out what is happening. At 4 or 5 months, parents can be more insistent on eliminating developing habits."

The good news is that babies quickly adapt to changes. He says, "Babies learn quickly, so changes can been seen as early as 2 to 3 days and up to one week. Babies who cannot sleep because they are frightened may take longer, as well as a baby who has medical problems."

And if you wonder whether or not it's OK ok for babies to sleep with the parents, he says, "The decision is based on the parents' philosophy. If they want the baby in the bed, then have the baby in the bed. But think it through. If they want the baby in bed, they must do it from start to finish. The parents must be consistent. Babies do much better when they know what is happening and what is predictable.

"The idea that one is better than the other is a misconception. Co-sleeping, not co-sleeping, same room, not same room, crib bed, on the floor, does not matter," he says.