Sleep training: Weighing up the potential risks and benefits

Many parents consider sleep training their baby at some stage. It’s especially common when babies start having more wakeful periods, which is on average, at around 4 months, 8-10 months, 12 months, 18 months, and then at 24 months. This is when a baby is experiencing massive brain growth, which often naturally leads to increased night wakings, resisting or taking shorter naps, or generally being extra fussy or unsettled. It can be incredibly challenging and exhausting, so of course you feel like you need to do something about it.

If you’re on the fence about sleep training, or don’t know where to start, here’s what researchers know and what they don’t know about its efficacy for tackling sleep issues. Taking onboard this information, you can then weigh up the potential risks and benefits to make an informed choice whether to move forward with it or not.

What is sleep training?

Sleep training became popular in the 1950s, when the idea that a baby’s normal night wakings were ‘problems’, and the focus was to fix them. However, the recommendation to sleep train was made before any research was done. Sleep experts have successfully convinced parents over the years that babies don’t know how to sleep and they need training to learn how.

Sleep training is essentially modifying a child’s behaviour, from extinction training (cry it out) to the ‘gentle’ methods that may include ‘camping out’, ‘controlled comforting’, or ‘gradual withdrawal’. All have the same aim of changing a baby’s normal behaviour. This is based on an outdated discipline of psychology, but today it has been replaced with developmental neuroscience and developmental psychology. We now know that behaviour is driven by thoughts and feelings. In other words, babies wake because they have a need, which may be physical or emotional.

What are some of the claims made about sleep training?

Sleep training is so ingrained in our Western culture that families often do it because they think they should. You may have been given baby sleep books, or had friends swear by certain methods. We all want what is best for our children, and we’re all just doing the best we can with the resources and information we have. Let’s look at some of the claims to support sleep training, and whether the research backs these claims. They include:

  • Babies will sleep through the night

The goal of sleep training is to get a child to sleep longer stretches. However, studies have shown that sleep training has no effect on sleep before 6 months. In older infants, it has been found that it also has no effect on sleep, but rather it changes the parents’ reports of their sleep. Babies are actually still regularly waking, but they’ve learnt not to signal to their caregivers. It’s the parents who are are getting more sleep.

  • It teaches the skill of self-soothing so baby can sleep independently

There is no evidence of this. For self-regulation to occur, they would need a functioning prefrontal cortex (the thinking and reasoning part of the brain), but we know that this area of the brain doesn’t work in babies until they’re about 3 years old, so they’re unable to shut off stress. For this reason, infants require co-regulation. They need us to be sensitive to their cues by providing reliably positive responsive care.

  • Sleep training is safe for a baby’s developing brain at 4-6 months

There is no evidence when sleep training is potentially more or less harmful, as no research has been done. Babies’ brains are wired to be close to their parents, so separation and isolation can be stressful and terrifying—for some more than others as every baby has a unique temperament and response to stress.

  • Without it, your child will suffer cognitively, socially, and/or emotionally

This claim plays into the fears of many parents. However, any studies that have looked at the links between sleep and cognitive, social, or emotional development have been conducted on older children and adults. Of course, adequate sleep is important. It’s when our brain and body rests, consolidates learning, and without enough we struggle. But, from the multitude of studies, the research doesn’t suggest much of a causal role of extending sleep times or reducing wakings in cognitive development.

What are the potential risks of sleep training?

With the numerous clinical and real-world studies that have been conducted over the decades, we still do not know if sleep training causes harm short-term or long-term. No evidence isn’t equal to no harm. We need to consider whether any potential risks to the baby outweigh the positive effects on the parents’ sleep. Some things to keep in mind are:

  • The risk of SIDS is double when the baby sleeps in a room on their own, according to Red Nose.
  • There is a potential risk to breastmilk supply if a baby isn’t signalling during the night when they’re hungry or require comfort.
  • There is a potential risk to the development of emotional regulation in the infant. An infant’s immature brain requires co-regulation (support from their caregivers) to reduce stress.
  • There is a potential risk of increased stress. In a study of sleep training, babies were found to have high cortisol (stress hormone) levels during and three days after being sleep trained. It can be incredibly stressful for the caregivers as well.
  • When caregivers don’t respond to their baby’s needs, it could potentially impact their relationship and the template for the child’s future relationships (based on Attachment Theory research).

When is sleep training beneficial?

While sleep training doesn’t work to improve infant sleep, it will often improve the sleep of the parents (depending on the temperament of the baby). The decision to sleep train is your own, and there are unique situations when the benefits outweigh the potential risks, which include when caregivers have mental or physical health challenges, when they have multiple babies, or when they have little to no support. Parent from the heart, listen to your instincts, and do what you think is best for your family regardless of outside pressure.

What is the alternative to sleep training then?

As parents, we don’t always know why a baby is crying or waking during the night, but we must respect that the emotion behind it is always for a reason. Babies and young children simply do not have the brain power to manipulate. Responding to their cues for regulation can be exhausting at times, but babies need a ‘good enough’ parent (term coined by Winnicott, D, pediatrician and parent-infant therapist) to form a secure attachment. We don’t need to be perfect because then it gives babies a chance to experience negative feeling emotions as well, which is a normal part of life.

Get to know your baby and try to learn what they’re communicating. Babies don’t sleep like adults do, and every baby and every caregiver is different. Ditch the schedule, and instead observe and listen to your baby’s signals and respond to them warmly, sensitively, and empathetically. The alternative to sleep training is to support normal infant sleep as it develops. Here are 10 tips to get you started:

  1. Learn to recognise your baby’s tired signs. 
  2. Accept that infants require nighttime parenting, not just daytime, and that night waking is developmentally normal and actually beneficial.
  3. Babies develop the ability to fall asleep and stay asleep over time. While the developmental skill develops, we can improve sleep conditions. Read our 6 tips to holistically optimise your baby’s sleep. Plus our simple tips to settle your baby to sleep.
  4. Understand what melatonin is, and how it can help your baby to sleep better.
  5. Consider the benefits and advantages of co-sleeping or safely bedsharing with your baby – read these guidelines from Red Nose
  6. Understand what the fourth trimester is like from your baby’s perspective.
  7. Read our top sleep tips for baby – first 6 months, plus our baby sleep expectations – 6 weeks to 6 months.
  8. Check out our guide to blissful baby naps: 6-12 months
  9. Look after you, and support your own sleep. Here’s how to cope with new mummy stress and lack of sleep.
  10. Here are the signs you need to seek professional help when you’re sleep deprived.


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