1. Both parents must agree to this plan before they start. If one parent does not agree and lets the child up after starting the program, the child will quickly learn to be more persistent. It is best to start the program when parents are well rested and don't have to get up and go to work the next day (usually on a weekend).

2. If the child is still taking a bottle to bed or waking for a nighttime bottle or nursing, it is important to eliminate the nighttime feeding first before starting the sleep program. (see Trained Night Feeders & Night Awakening)

3. Evaluate how long it now takes to get the child to sleep or how often the child wakes at night. A written diary is important to help establish this information. The diary should also include data on daytime naps.

4. Establish a nightly routine: snack, bath, pajamas, story, and good-night kiss; then it's off to sleep.

5. On the first night be prepared for the child to cry. Often it may be longer than an hour depending on whether the family had let the child cry intermittently before. The parent can go to the child after 5, then 10, then 15 minutes. Do not take the child out of bed. Make sure the child cannot fall out of bed and that the environment is safe.

6. If the child awakens during the night, the same plan should be used. Check on the child but do not allow him or her to get out of bed. The goal is to teach the child to fall asleep alone, without being held, rocked, or fed.

7. In the morning, the child should be awakened at the normal time. Everyone may be tired the first day or two, but that will quickly correct itself.

8. It usually takes only three to five nights of consistency before the child is going to bed and sleeping all night. Usually on the second night the child cries less than on the first night, but occasionally may cry longer. This longer period of crying is called an extinction burst; behavior one is trying to eliminate increases before it decreases. It occurs more frequently if parents have attempted to let the child cry at night but have been inconsistent in the amount of time they let the child cry.

Also see (Bedtime Refusal)

PREVENT SLEEP PROBLEMS

• Put the baby to bed sleepy but awake.
• Place the crib in a separate room so that the baby has a quiet place to nap and sleep, and the parents have privacy.
• Eliminate long daytime naps and get the baby on a routine. Keep the baby from becoming over tired; this can cause undue fussiness and difficulty getting to sleep.
• Make middle of the night visits brief and boring.
• Check with daycare providers to make sure they are following the some routine.
• Start decreasing the amount of nighttime feeding the infant is getting.