The Case Against Ferber Sleep Training

by Dr. Laura Markham

I'll admit up front that I'm biased against Ferbering. As an attachment psychologist, I believe that babies need to be picked up when they cry. I have found that there are kinder, gentler ways to teach babies to put themselves to sleep (see Elizabeth Pantley's No Cry Sleep Solution). And with all due respect, Richard Ferber is trained in physical health, not mental health. He readily admits that he is not trained in infant psychology.

Most interesting, while his book is still out there circulating, Ferber apparently has a new book coming out, and now he's saying in interviews that he regrets some of the advice he gave before. He's been quoted as saying that he feels badly that child health professionals are encouraging parents to leave very young babies to cry, and that it's ok to co-sleep.

In case you're wondering, here's how Ferbering works:

You let the baby cry for five minutes, then go in to reassure him verbally and by patting him. You don't pick him up. Then you leave, let him cry for another ten minutes, then go back to reassure him again. This time, you let him cry for fifteen minutes, then go back to reassure him.

If the baby vomits, you clean him up, (preferably without picking him up), but leave him in the crib and continue with the Ferbering. Each time you leave, you wait longer to return. With a very determined and resourceful baby, this crying can go on all night, but more usually the baby will become exhausted and fall asleep after a few hours. When he reawakens later in the night, the process is repeated. Sometimes the next interval of crying is shorter, sometimes not. Usually the crying diminishes on subsequent nights.

While listening to their baby cry is hard on parents (not to mention the baby), most babies do eventually give up calling for their parents, and sleep. Because they do not yet talk, and live so completely in the moment, we do not hear from them the next morning how they felt about the experience.

However, even when parents are consistent, this approach does not work on all children. It is not uncommon for babies to get an ear infection in the middle of it (from the congestion caused by the crying); it is recommended that the Ferbering be discontinued during the round of antibiotics that follows, to be re-initiated later. In addition, since any change in the routine (a brief illness, a trip to Grandma's) requires parents to respond to the baby's cries and then to repeat Ferbering on another night, this process must be endured repeatedly by both baby and parents.

I'm not aware of any research that follows children over time to see if Ferbering is a risk factor. There is, however, one British research team that claims to have proven that repeated, sustained crying without adult reassurance actually causes babies' brains to develop less than optimally (see Margot Sunderland's The Science of Parenting).

There are also a growing number of critics who see Ferbering as barbaric. Their position can be summarized as follows:

1. Richard Ferber is a pediatrician with no psychological training. While his approach works on some babies, it may not be simply "teaching them to sleep in their own beds", as Ferber maintains. Other, less desirable lessons are unwittingly being taught.
2. Your baby is learning that you cannot be depended on, and in fact will regularly desert her when she needs you most; that she is powerless to have an impact on her world in the ways that most matter to her; and that her world is a cold and lonely place.
3. Finally, she learns by your coming back into the room to reassure her but not actually helping her that you really don't love her, and thus concludes that she is not, in the deepest dark of the night, really lovable. She may even conclude that you are intentionally tormenting her.
4. It is possible that these early lessons will underlie her sense of self and worldview for the rest of her life. Insomnia is rampant in our culture, and some Ferber critics argue that all those adults who can't fall asleep without the TV on, or who wake up at night and can't sleep, are Ferber casualties.

I should add that I've heard that there are families where the baby learns to fall asleep with a few minutes of crying and never needs to be retrained. In those cases, it seems a wonderful solution.