As a pediatrician, the most common question asked by parents is “How can I get my baby to sleep through the night?” After 15 years in practice and my own experiences as a mom of four, I will share some insight.

My oldest child magically slept 8 hours and NEVER woke in the middle of the night after 8 weeks (do not be jealous, there are a few more kids to go.) Seven years later, he still sleeps through anything, including the fire alarm, which is not necessarily a good thing. My second was a blonde haired, blue eyed cutie who threw up during and after every feed. At 2 am, in the pitch dark, he would choke; I would hold him over the garbage can to throw up and get right back to nursing without missing a beat. Two months, four months, and six months came and went. He continued to eat and throw up at 2 am and eat again at 5 am. When he was 11 months, I was pregnant with number three, working, taking care of a two year old and utterly drained. I decided to ‘teach him to sleep independently’, otherwise known as “cry it out.”

Crying it out (CIO) has recently been found not to have damaging effects on babies; it is safe and effective. At 2 am, that first night, he cried for two hours and I was sobbing the entire time. The next few nights crying lasted only 30 minutes; followed by four blissful nights of 8 hours in a row. A week into sleep training, a final night of crying for an hour at 2am. That night was very tough, but I stuck it out. He never cried himself to sleep again. Interestingly enough, when he sleepwalks now, it frequently occurs at 2 am.

Our third baby turned out to be a natural nighttime sleeper, just like my oldest. By 8 weeks, she was down for her 8 hours and almost never woke in the middle of the night. I always knew having a daughter would be amazing! She is my favorite child to sleep with still because she is like a rock and does not move a muscle all night long.

I had a 4 year old, 3 year old, and an 18 month old when the baby arrived, and to be honest, I do not remember a thing from the time he was born until he was 3 months old. That summer was literally about survival, theirs and mine. Since we live in a three bedroom house, the baby slept in our closet until about 6 months, when sleep training felt necessary to put him in a room with a sibling. My oldest still talks about when “we” sleep trained the baby because it was Christmas break and he slept on the floor of our room for two weeks, which he loved. I do not remember how long it took but the baby cried a few nights and then stopped. By January, both boys were in the same room and it has been fairly smooth ever since. Currently, three boys are in one room and our daughter is in her own.

Are they solid sleepers because of sleep-training or sheer genetic luck? The truth is, I have no idea. This is another do-what-feels-‘right’-to- you-as-a-parent things. Babies under 4 months of age should always be comforted when they cry for both nourishment and reassurance. Developmentally, once a baby is 4 months, they are medically able to go 8 or more hours without feeding. If exclusively breastfed, it may be closer to 6 months because human milk is digested faster and the stomach empties more quickly.

IF parents wish to do so, those ages and older are acceptable times to sleep-train. When you sleep-train, think about what you do that encourages a baby when he wakes at night: picking him up, nursing, and rocking him to sleep. None of these comforting things are bad for your baby, they just do not reinforce putting oneself back to sleep. A moderate approach is to remove some nighttime reinforcing behaviors in a gradual fashion, based on what a parent can tolerate emotionally.

“Crying all night in pain” is not recommended and not the essence of sleep training. Sleep training is parent and child dependent and is NOT medically necessary. Learning to put yourself to sleep is a skill and may be a developmental milestone, but every child develops at a different rate. Sleep training helped me feel sane and rested. I sleep trained two of my own children which basically makes me an expert with mine, but not necessarily yours. The decision to sleep train is entirely up to you.

A bedtime routine can be helpful. We do baths, fluoride, stories, brush teeth, and snuggles. Learning to put themselves to sleep can foster independence early on in life. Surprisingly, all of mine have said “its time for me to go to bed” at one point or another and they walk upstairs and climb into bed, confident in the knowledge they are tired and need their rest. Our job as parents is to give them confidence to know what their bodies need to be healthy and grow. Sleep training, while not for everyone, might be easier to think about as teaching your child good sleep habits that will last a lifetime.