Method: Ferberization/Cry it Out/"Graduated Extinction"
Expert:
- Dr. Richard Ferber
- the Director of The Center for Pediatric Sleep Disorders
- Author of Solve Your Child's Sleep Problems, published in 1985, updated in 2006
(The above site provides the facts and myths of the method including a brief explanation about what's updated in the 2006 edition of his book.. Apparently, he's 'warmer and more relaxed' as well as more open to different approaches)
How to:
For babies at least 6 months old:
1) Take steps to prepare the baby to sleep. This includes night-time rituals and day-time activities.
2) At bedtime, leave the child in bed and leave the room.
3) Return at progressively increasing intervals to comfort the baby (without picking him up). For example, on the first night, some scenarios call for returning first after three minutes, then after five minutes, and thereafter each ten minutes, until the baby is asleep.
4) Each subsequent night, return at intervals longer than the night before. For example, the second night may call for returning first after five minutes, then after ten minutes, and thereafter each twelve minutes, until the baby is asleep.5) If baby vomits or defecates, clean him/her up in a matter-of-fact manner, put him/her back and leave the room again so as not to deviate from the training.
Ferber made some modifications in the 2006 edition of his book Solve Your Child's Sleep Problems. He is now more open to co-sleeping and feels different approaches work for different families/children.
Pros-Cons/Testimonials
Pros:
1) Kids who complete training are less likely to throw bedtime tantrums
2) Kids who complete training are more likely to settle down at night within ten minutes
3) Kids who complete training are less likely to awaken their parents during the night
4) Parents who complete training report improvements in their own stress levels, mood, and interactions with their children
Cons:
1) Insufficient studies to measure the long term effects on children's:
• physiological stress response
• attachment relationship with parents
• emotional development
• personality development, or
• expression of physical affection
2) Not appropriate for children with a conditioned fear of being left alone as well as children with conditioned vomiting response
3) The method is not designed to treat most sleep problems that cause night wakings e.g.nighttime fears and separation anxiety , daytime stress, nightmares , snoring and other forms of sleep-disordered breathing , nocturnal headaches and other painful medical conditions, circadian rhythm sleep disorders, sleep walking and/or night-terrors ..etc
More: Ferber method and its alternatives
AskBaby.com
Attachment Parenting vs. Ferber Method
Personal opinion: This method was already 'popularized' through tv shows like "Mad About You" and movies like "Meet the Fockers 2", to name a few. A friend whose sister used this method told me that as the baby cried inside the room, the parents were crying outside! From what I read in the sites, it seems that his 1985 edition of his methods were more rigid and his updated version in 2006 is more relaxed as well as open to different approaches. Personally, I am not in favour of leaving my baby alone in a room to self-soothe or cry herself to sleep. As some of the sites suggest, there are alternatives to this method which are less distressing! The above site: 'Ferber method and its alternatives' gives a very comprehensive view of this method so check it out!
Carpe Diem, ladies!
Becky
39 comments:
wow, very comprehensive links, and evidence-based too :)
i didn't know that there was so much research in this area!
i get the feeling that authors from different poles of sleep-training are beginning to strike a balance and somehow find some middle-ground so that they're not too extreme.
good job, becky!
Thanks,I think so too...
I guess when they first started (80's or earlier?), they were like "Only THIS method works!" but after a few more years of practice and experience (and meeting thousands more babies), they're probably like, "Hmm..ok, maybe different babies, different approaches."
There are a lot of info on AP and Ferber. The Baby Sleep Site you recommended is probably fairly new so less info and studies/research on it so far.
Becky
since you are "pro-Sears method", how come your baby is not napping well at 9 months+ as you mentioned in your earlier article (sarong: good or bad?)? i think its ok if she doesn't nap well at times but if it happens on a regular basis, then what?
mebe I can share a bit bout the unpredictability of babies.
my boy just turned 8 mths.
we were ecstatic when he went to sleep 1 nite without so much as a squeak (mind u, still some carrying & lulling in daddy's arms till drowsy before being put down)
the next day, which happened to be a saturday (read full-time with mummy & daddy, grandma's day off) my hubby was a bit upset that our boy refused to nap in the daytime quietly in his arms as usual but had to be nursed to sleep. Grandma got the blame for the 'bad habit' of relying on a milk to induce sleep.
well, i just reminded both of us that our boy is a little human being and not a robot, somedays he'll just be fussier than others and he can't be expected to 'perform' acc. to a script or programme.
a wise old man once said that the only thing certain in life is change....
Almost every sleeping method seems got pros and cons. Like using sarong & pacifier.
i don't really like to follow books ... the theories. i prefer to listen and see from experience mothers, how they take care of their children. when i have my 1st child, in a lot of things, i'll ask my aunty, my parents, my bro's wife ... to know their ways. i think all their advise are very precious to me. they use it, do it for their child and is a success example.
i use also sarong (only at babysitter for nap) and pacifier at night. i've never carry my babies to sleep. i give them last bottle of milk, drink a little water (to wash to mouth) then give them pacifier. then, after a while, they fall asleep. but thanks also to my 1st confinement lady, to train my girl to play and sleep at right time during confinement.
ABC: Hmm..if I may use a few of the methods to explain my situation..
As Ss mentioned,every sleeping method has its pros and cons and I agree very much to that.
When I say I'm pro-Sears/AP, I'm all for the principles of AP e.g. Co-sleeping,nursing baby to sleep, and having the right 'attitude' about night time sleep. In other words, the attitude they're referring to is- just accept the fact that your baby WILL wake up at night and enjoy it since your baby will not remain like that forever..so after awhile, I'm used to it.
However, having the right attitude about it doesn't make me BIONIC woman. I do get tired and sometimes stressed because the method propogated e.g. nursing to sleep causes my babies to have all these sleep associations. For my first girl last time, I had to break the sleep associations as Nicole Johnson said, because I couldn't keep up with it anymore. When I can't keep up with it anymore, it becomes a problem to ME. Hence, I weaned her off which involved a bit of crying for a week. I think that may be similar to what Ferber advocates although I didn't follow it completely e.g. I didn't leave her in the room to cry, I picked her up and cuddled her a lot vs. self-soothe.
By 11 ++ months, she was sleeping independently. But as laifchan said too, babies tend to be unpredictable.
So, in a nutshell, I think there's no one perfect way.. sometimes just have to try and see what works with different babies. I think being parents involve accepting the fact that 'Hey, we're not perfect, but we're doing our best'..
As for my 2nd girl, I have yet to try a different sleep association. Once successful, I'll let you guys know. :)
Also, if I may add.. whatever method we adopt depends also on what we as parents are wiling to sacrifice/put up with..
For example, Ferberization may be a very quick-fix solution. Maybe if I tried that, my baby can sleep through. But am I willing to put her in a room to self soothe and cry it out? Uh uh..
Since I'm pro-AP, just also have to accept the cons together with the pros of this method. Meanwhile, since I don't intend to have more babies.. I'll just enjoy this one and every day thank God "Last one, last one..."
babies won't be consistent. i notice after a period of time, there will be changes in the trend i.e. their sleep style or duration, milk intake, etc. like milk intake, there's time when suddenly the baby don't want to finish off where they used to finish the milk all the time. they are not sick ... they just suddenly change their routine. when some routine changes suddenly, some older people will say that is due to the baby learning new things. don't know true or not. however, this changes will happen but things will get better after few days or few weeks. so, no worry ... is just normal. i think all mothers will experience that.
try not to be too perfectionist ... it's not really a big deal what method to use. what is important is which one work best not only for the baby and also for the mother. we don't want to have nervous breakdown or getting into depression. well, sound too serious but is something that do happen.
Ur right Ss, when my first girl started drinking milk from the bottle, she would finish the WHOLE bottle (270- 300 ml). Suddenly, one day she started leaving 60ml behind everytime..As you said, for no particular reason. Then after a period of time, she's back to drinking and finishing full bottles of milk again.
amen again.
can't over-emphasise the importance of maintaining good mental health.
yes, depression and anxiety are real issues but there are things we can do to reduce the risk of developing these when we're under stress.
1) acknowledge our limits
- if caring for a baby is taking a toll on us due to multiple commitments ie work, lack of sleep etc, there are steps we can take:
a) get help:
support important, involve daddy at night and extended family to help look after baby
b) take a break
-take some time off work to just recuperate and get a babysitter/relative for a few nights while u chill out with your spouse (if he's not contributing to your stress!)
c) take stock
- take some time to reorganize your routine and time management. a little bit of stress over a few minor issues can add up to something rather significant.
Just to share, I was practically tearing my hair out trying to meet datelines, juggle academic, administrative and clinical work in the hospital while struggling with sleep deprivation at home. Plus, had to travel outstation for work a couple of times these few mths and worried about continued breastfeeding, pumping & storing on the road.
U can imagine a fixed routine for our baby was nearly impossible.
My husband (whom I must say is very supportive) decided to book 2 nights in a nice (internet-discounted) hotel next weekend after I return from a student camp so that we could have a sorta working holiday for me (need to just be able to sit down an write a journal article with a clear mind).
Fortunately, my in-laws will be around to look after our son for a night and the 2nd night, he'll be with us in the hotel.
Just the prospect of a break is something to look forward to and keep me going :) and we plan to take breaks from our routine on a regular basis.
Of course, sharing and hearing from all of you and knowing that I don't struggle alone is also very therapeutic so here's a big thank you to everyone for helping me keep sane!
laifchan: Two thumbs up to your considerate husband! and you're welcome. I'm glad that this mama blog is helpful and therapeutic to you too!
I do think breaks like a getaway is very rejuvenating and helps us recuperate from exhaustion and the daily grind of things. It's not realistic to expect ourselves to keep going like clockwork without a hitch or a glitch.
Hmm.. speaking of getaways, what do you guys think of a Carpe Diem Mama Retreat? Hahaha... Wouldn't it be nice to have bunch of mamas get together to have some girl time minus hubby/baby/work/chores/datelines? Nothing in the works yet.. just a thought..
Haha, talking abt mental health, I have something to share..
I'm wondering what's wrong with me lately. I get irritated easily by minor things eg the way my husband looked at me, my baby's scream for no apparent reasons etc. I developed this malaise to do anything and everything. I used to enjoy structured courses like Disciple, but now I dread it.. all I want is to stay home and have zero social, TQ! But if I spend too much time at home, I feel so unproductive and SO BORED! It affects everyone around me. Argh!!
I must clarify here that I have a very supportive and understanding husband, my son is adorable and easy going most of the time, we have no financial burden, my extended family is wonderful..
Maybe I'm still adjusting to life with a little one? Maybe I should see a counselor?
I would recommend exercise, facial and doing charity. :) but then again that's what works for me.
perhaps laifchan can advise since mental health is her area of specialization?
its normal to have ups and downs
BUT you should seek help when you find that your mood is persistently low (crying spells) or irritable, can't enjoy what used to be pleasurable anymore, future looks bleak, can't sleep, can't eat, losing weight, lethargic AND you have difficulty functioning at work, home and socially.
Counsellors are ok but my advice is to see a doctor (your trusted family physician) to get an opinion whether you may be having depression or other mood/anxiety disorders and whether you need to be referred to a psychiatrist (you can also see one directly) because its important to get proper treatment early which may include medication and therapy from psychiatrist.
also, its important to see a doctor because some medical conditions that can be treated may affect your mood ie thyroid disorders (hypothyroidism)
becky, when one prefer to stay at home and zero social, i don't think she will want to do exercise, facial or charity.
Re Gal, don't just leave it that way. things might not be as bad as you think. must find someone to talk to. someone u feel easy to talk. sometimes, by just expressing out what is inside will make u very much better. if u can't trust anyone, well, counselor or phyciatrist doctor will be a choice. or, just treat this period as giving yourself a long break but give yourself a deadline to get back on track.
talking to someone is definitely helpful but when one is depressed, one maybe socially withdrawn and have difficulties in having normal social interaction
depression is something you can't just snap out off without proper help.
my advice is that you seek professional help together with support from your family and friends so that you give yourself the best chance of getting well.
when untreated , depression can run a severe (risk of self-harm) and prolonged course which is totally unnecessary-time lost not being able to function and unnecessary suffering.
I have a ques, laifchan:
If a person experiences regular feelings of sadness or hopelessness over events which are out of his/her control but otherwise is able to function normally, would he/she need any form of professional help? Or he/she just needs to adopt a more positive outlook?
I read that melancholic people are more prone to this kind of feelings. Thru ur research and study,is clinical depression more prevalent in certain personalities e.g. melancholic \than others?
Thanks all for your kind words. Yes I have many symptoms the good dr said but I'm also a melacholic/S.. So is it normal to feel this way? I can still function everyday but I can't say that I'm living life to the fullest.. Any psychiatrist in Kuching that I can consult?
yes, certain personality traits can predispose some people to depression, most evidence for obsessive traits eg too perfectionist, rigid, extremely particular about cleanliness (to the extent it interferes with daily routine and relationships with others-pretty subjective)
you are referring to melancholic as in sanguine, choleric etc? We don't really use this classification and melancholic features refer to something more technical in psychiatry, which I will not bore you with.
Impaired ability to function simply means that you're not functioning to your optimum level as usual, this includes interpersonal relationships ie more frequent arguments, easily irritable over things that didn't seem to bother you.
Also, a good indicator is when you yourself or others notice a definite change from your usual self. Sometimes, this may happen without any obvious reason/stressful event but that doesn't mean that the depression is not there or doesn't need treatment.
The degree in disruption in function may reflect severity, when not so severe, still can work but maybe have to drag your feet doing it.
I'm sorry, don't really know who is in Kuching but Kuching General Hospital will definitely have at least 1 psychiatrist especially with UNIMAS having psychiatry lecturers there.
to answer becky's question, u mean someone who is generally pessimistic about life but seems to function pretty ok?
well, its a bit of a gray area.
we do see people who have described themselves as being blue as long as they can remember. They usually come to our attention when the depression is more severe and function is impaired. Sometimes the depression appears chronic and its difficult to draw a line where the person's "pessimistic" personality developed into clinical depression.
There is a type of depression called dysthymia which is a bit more chronic. Some authors have argued for what they call a dysthymic personality type.
There's 2 pychiatrist doctor in Kuching. 1 is Dr. Yap but i'm not sure where is the clinic and the other one is Dr. Chan (beside Timberland). At Dr. Chan's clinic, there's a counselor, Joyce Lu. if needed, Dr. Chan will refer to the couselor.
Dr. Yap is older so maybe more experience. Dr. Chan's is younger. his clinic opened in 2008.
Re Gal: I have seen Dr. Yap before (er, not me but I brought a friend there before). His clinic is along Jalan Batu Lintang. If you'd like to see him I'll help you get the details.
Mmm.. Not sure what I will do.. But will start to make time for myself. Hopefully it'll improve.. If not, I know where to find help. Thanks everyone!
Oh, I just saw Ss and Becky's comments. I'll let you know if I need the doctors' details. Thanks ya.
Hi Ashok, are you saying that whatever Re Gal is going thru is due to lack of sleep?
hi becky, lack of sleep may be one of the reason for Re Gal. The reason for sleeplessness should be rectified first, then only proper treatment can be taken.
Interesting that you would raise sleep apnea as a possibility..
Must read up on it..
So a person may have sleep problems and not realize it?
Thanks Ashok. Welcome to our group..:)
i'd like to point out that there's differences between psychiatrists and psychologists.
laifchan, in case i've missed it in any of the earlier readings, what exactly is your background (education etc) and where are you based (company etc)?
Hi zin, welcome to our group! Perhaps you'd like to introduce yourself too?
Anyway, I'd just like to remind all readers that for safety reasons, let's err on the cautious side when it comes to revealing our personal details: e.g. place of work/residence/phone numbers/ kids' schools...
Only because we don't know who else might be reading besides mamas. :)
Thank you.
yes becky, i agree w u on no personal details...
since laifchan's writing is based so much on her professional experience, her educational background would be helpful eg. what degree and where its obtained.
Re Gal, as women we go thru ups and downs...it's hard to get out of the downs when we are down...I feel quite unproductive at times but it's those times that I seek the Lord and ask Him for the inspiration by the Holy Spirit...it may take a few weeks of downs to get up but the Lord always is there for me.
Do note that as women facing 2 types of hormones running through our bodies during the month (whereas men have only 1, those lucky dogs), we are battling one (estrogen) which may be high and low during certain times of the month and the other (progesterone) which is ditto. Do note your menstral cycle patterns as it might have something to do with your mental thinking.
do engage in a hobby individually or as a family
your comment on wanting to stay home and zero social is legitimate...many times we get so engaged with our children that not being around anyone or anything is more sound to our minds than socialising.
we are always here to listen if you want to share your thoughts because you are well loved here....
take note that we all go thru what you go thru from time to time...we are all in the same boat so know you are not alone.
TQ ShD and others on your care and concern! I am very touched and a bit embarrassed by the attention.. I feel much better now, def coming out of the blues. I like to thank all for your advice and kind words, indeed I am not alone :) Sorry Becky for 'hijacking' this post.. did not foresee the overwhelming response.. sorry ya, mate :)
Hey, Re Gal! That's what SUPPORT group is all about (even tho it
is online)!! ShD said it well, so no reason to feel embarrassed... :)
Re Gal, this is the reason our wonderful Becky and her friend laifchan set up this blog...so we can help each other.
It's good to know what is honestly going on in your life. NO NEED TO FEEL EMBARASSED!
We are all in the same boat in experience from time to time.
I'm SOOO GLAD you are feeling better. Next time you feel sad or just need someone to listen, write and we're all EARS, just like Bugs Bunny...hehehehehe!
Awwwww... thanks, ShD, for your kind words. It is my wish that our blog becomes a platform for encouraging words, positive discussion and supporting mamas in their struggles.
Ss: re: your comment on "babies won't be consistent", I believe it is due to spurts in growth. As they change and grow, their cycles of feeding/eating, sleeping, playing also change.
Thumbs up to those mamas who stay positive and roll with the changes. It's not easy so let's support each other with late night, frustrations over baby cries, overall fatigue from lack of sleep and overwork.
Thank you Delighted..
"Positive", "Support" - key elements to survive motherhood mania.
really an eye opener for me.
- Robson
Thanks for visiting Robson, do come again soon...
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