The Surprising History of Sleep Training

Sleep training is a big deal around here. If you’ve spent any time as a parent in a western country, you’ve likely had someone suggest sleep training to you. Actually, it’s basically assumed that parents will sleep train at some point and presented as a rite of passage. It’s really hard to escape- even pediatricians are commonly recommending sleep training. When my first child was six months old, I received a handout with instructions for sleep training on it, and I’ll never forget one thing that it said:

“If your child cries, don’t return to them, or they will learn that you will keep responding to them.”

Well… yeah, that’s kind of the point, right? I want my child to know that I will respond to their signals.

But, I digress.

Non-responsive sleep training has somehow become the “norm”. It’s just what is expected of parents, and it is considered the gold standard in many circles. In our current culture, parents are pressured to ignore their own intuition which usually tells them to respond to their babies’ cries and keep them close. Parents are also made to believe that they are somehow harming their baby, or at the very least not setting them up for success and teaching them the skills they need to be teaching them, but responding to them and supporting them with sleep. But it hasn’t always been like this. A child having their own crib in their own room was basically unheard of for most of human history, and is still unheard of in many cultures. And a child being left alone as they cry to “teach” them sleep? That wasn’t happening hundreds of years ago, at least not on purpose. (Want more information on how babies are actually meant to sleep, from a biological and developmental perspective? Grab this free resource, and I’ll walk you through it.)

So how did we get here? In this blog post, I’m going to explore the history of sleep training and how it got to be a massive part of the mainstream parenting paradigm today.

The cultural shift of the industrial revolution

It appears that a cultural shift began to take place in the 1800s during the Industrial Revolution that changed the way doctors and parents perceived infants’ sleep and feeding patterns. This is when the medicalization of motherhood and parenthood took off, that is- mothers began looking to the advice of “experts” (usually doctors or other self-proclaimed parenting experts) to tell them how to parent. It’s interesting to note that this is also around the same time when the medicalization of birth began, and birth began moving from the home to the hospital. It was with this shift towards medicalized childbirth that more separation-based practices between mother and baby were also occurring. 

It makes sense from a cultural perspective because a massive shift in the way humans lived occurred during this time. There was a shift from living intergenerationally and getting parenting wisdom passed down from their parents and grandparents and aunts and uncles- to moving to larger cities to work in factories, which essentially ended the intergenerational living for many families. Not only this, but people were often very overworked and exhausted with the introduction of shift work and women entering the workforce, so getting babies to adapt to the family’s schedules (including sleep schedules) was a welcome new idea.

Some of the first literature about sleep training came about in Germany between the 1830s through the 1890s. This literature focused on helping babies get on sleep schedules and encouraging parents to not rush to comfort babies, but rather let them try to resettle on their own. However, these doctors and experts also recognized that some babies will not be able to resettle on their own and that parents should not be rigid in their approach to sleep. (1)

In the late 1800s, there was a rise in concern over germs, and parents were encouraged to not touch their babies so much to prevent transmission of infection. 

In 1891, Dr. Anna Fullerton wrote A Handbook of Obstetric Nursing in which she advised parents not to pick up their baby every time they cry.

“If a baby is picked up every time he cries, he will soon develop the habit of crying insistently each time he wakes until the mother does pick him up…. This is not a good habit for the baby or the mother. It interferes with the baby’s sleep and with the mother’s work or rest. It teaches the baby that crying will give him control over his parents, whereas a baby should learn that such habitual crying will only cause his parents to ignore him.”  (2)

A few years later, in 1894, Dr. Luther Emmett Holt published a book called The Care and Feeding of Children (3), which is one of the first pieces of literature popularizing non-responsive sleep training similar to how we know it today. In this book, he states that in the first two days of life, babies should be fed “only four or five times daily, since there is very little milk secreted at this time”. Holt also advised parents to follow a very specific feeding frequency schedule in the first year of life in which he asserts that babies 5 to 12 months old do not need any night nursing sessions between the hours of 10 pm to 6 am. He advises mothers to complete weaning from the breast by 1 year and states “the dangers of weaning are much less than those of continuing to nurse, as is so often done, after the milk has become very scanty and poor in quality.”

Let’s move on to his advice regarding sleep. Holt states that an infant should never sleep in the same bed as his mother because “there is always the temptation to frequent nursing at night, which is injurious to both mother and child.” He goes on to suggest that night wakes are “habitual” and often caused by food or feeding (in other words, it’s the mother’s fault for feeding her baby too much), or that they are caused by “bad habits” like “when the child is taken from its crib whenever it cries”. 

Although a quick, side note here: Holt actually points out that one cause of disturbed sleep is due to airway obstruction from enlarged adenoids and tonsils, something you don’t hear many pediatricians talking about today! So, essentially, even one of the grandfathers of sleep training acknowledged that there were many causes of sleep disruption and that cry it out wasn’t the solution to all of them.

Holt’s book was perhaps the first that mentioned the idea of crying being good to expand a newborn’s lungs. It is almost certainly the first time the term “cry it out” is mentioned, at least in published literature. Let’s read what Holt has to say about how a mother should approach a baby who cries out of “temper, habit, or to be indulged”:

“It should be simply allowed to “cry it out”. This often requires an hour, and in extreme cases, two or three hours. A second struggle will seldom last more than 10 or 15 minutes, and a third will rarely be necessary.”

Thus, “cry it out” sleep training is born!

The behaviorists become parenting “experts”

Fast forward to 1928, John B. Watson published his book, Psychological Care of Infant and Child. (4).

John B. Watson was a behaviorist. Behaviorism is a theory of learning that suggests that all behaviors are learned from the environment. 

In his book, Watson states:

“Parenthood, instead of being an instinctive art, is a science, the details of which must be worked out by patient laboratory methods.”

In his chapter on day and night routines, Watson walks parents through a rigid nighttime routine and advises them to give the child and room one last look over to make sure everything is in place and all needs are met, turn the lights out and close the door. 

“If he howls, let him howl. A week of this regime will give you an orderly bedtime.” 

Watson believed mothers must not give their child too much emotional attention so that they could be a blank slate to shape, and he advised mothers to shake hands with their children upon waking. He also encouraged parents to strap their 8 month old infants onto a toilet seat and leave them in the bathroom alone. His own granddaughter, Mary Loretta Hartley, had this to say about him:

“Grandfather’s theories infected my mother’s life, my life, and the lives of millions. How do you break a legacy? How do you keep from passing a debilitating inheritance down, generation to generation, like a genetic flaw?”

Sounds like someone we should possibly think twice before taking parenting advice from. 

In Darcia Narvaez’s 2011 article, ‘The Dangers of Crying It Out‘ (5), she describes a government pamphlet issued around the time of Watson:

“A government pamphlet from the time recommended that ‘mothering meant holding the baby quietly, in tranquility-inducing positions’ and that ‘the mother should stop immediately if her arms feel tired’ because ‘the baby is never to inconvenience the adult.’ A baby older than six months ‘should be taught to sit silently in the crib; otherwise, he might need to be constantly watched and entertained by the mother, a serious waste of time.'”

Parenting “experts” of the 1940s and 1950s soften sleep training

Fast forward to the 1940s and 1950s when new parenting “experts” were on the rise, and they gave parents new and different options than the rigid and cold sleep training advice from men like Watson. 

Most of us know of Dr. Benjamin Spock; he wrote a very popular book called Baby and Childcare (6). While he rejected Watson’s cold treatment of babies and children, he still promoted similar rigid sleep and feeding schedules, and also encouraged parents to get their babies sleeping through the night early on. His techniques felt warmer to parents, yet they were born from the very same parenting ideology of his predecessors. While new parenting “experts” like Dr. Spock and others of the time made parents feel like they had options, they also solidified this ideology of training babies into the cultural “norm”. Soon, it was no longer a question of whether babies should be sleeping through the night or whether parents should sleep train them- but a question of “when” and “how”. 

During this time period, we can see how theories and ideologies that weren’t rooted in developmental science became viewed as facts. 

Modern day sleep training, as we know it

In the 1980s is when we begin to see our first glimpses of modern day sleep training. Two doctors published incredibly popular books that introduced sleep training ideas and practices that largely shape the current sleep training strategies that are popular today. Around this time, we notice an increase in the medicalization of normal child sleep- in other words, we see normal child sleep and feeding patterns increasingly being labeled as medical problems that require interventions to solve. 

In 1985, Dr. Richard Ferber published Solve Your Child’s Sleep Problems (7). In his book, Dr. Ferber advocated for a method of sleep training called “controlled crying”, or “graduated extinction”, which is essentially letting a child cry alone for longer and longer lengths of time. Today, we still know this method as The Ferber Method, or “Ferberizing”.

It’s interesting to note that Dr. Ferber has since updated his book and publicly spoken out saying that his beliefs on sleep training have been misunderstood, and that the Ferber Method is not for everyone. Per NPR, 

“The so-called Ferber method, the approach of allowing a child to cry for longer and longer periods, he reserves only for those families who want to break what Ferber calls bad sleep habits.”

According to NPR, Ferber also changed his mind about co-sleeping and now believes co-sleeping works fine for many families. It seems his approach is now more a “do what works for your family” kind of approach.

A couple of years after Ferber’s book was published, another popular sleep book hit the bookstores. Dr. Mark Weissbluth published Healthy Sleep Habits, Healthy Child in 1987 (8). In his book, he advocated for complete extinction, or cry it out. Simply put, you put your child in their crib, close the door, and don’t come back until the morning, unless there is an emergency or they need a diaper change.

Since then, many other sleep training books and self proclaimed “experts” have come out with new sleep training methods, but they are mostly just variations of these techniques. Oftentimes, they are packaged with a gentle sounding name to make parents feel better about it, but most modern day sleep training techniques still involve some amount of non-responsiveness. 

The good news is that, while sleep training is still incredibly popular, and I’m not sure if that will change anytime soon, it also seems that responsive sleep strategies have gained popularity as well. More and more parents are deciding that sleep training isn’t right for their family, and thanks to the growth of social media, parents are now able to find communities where they feel supported and understood in their desire to respond to their children at all hours of the day.

References:

1. The history of sleep training in Germany – phd in Parenting. PhD in Parenting. (n.d.). http://www.phdinparenting.com/blog/2011/5/9/the-history-of-sleep-training-in-germany.html 
2. Fullerton, A. M. (1911). A Handbook of Obstetric Nursing: For Nurses, students, and Mothers: Comprising the course of instruction in obstetric nursing given to the pupils of the training school for nurses connected with the Woman’s Hospital of Philadelphia. P. Blakiston.
3. Holt, L. E. (1984). The care and feeding of children. New York & London.  
4. Watson, J. B. (1928). Psychological care of infant and child. Arno Press. 
5. Darcia Narvaez. (2011). Dangers of “Crying it out.” Psychology Today. https://www.psychologytoday.com/intl/blog/moral-landscapes/201112/dangers-crying-it-out 
6. Spock, B. (2004). Baby and childcare. Simon & Schuster. 
7. Ferber, R. (2013). Solve your child’s sleep problems. Vermilion.  
8. Weissbluth, M. (2021). Healthy Sleep Habits, happy child: A new step-by-step program for a good night’s sleep. Ballantine Group. 
9. Coukell, A. (2006, May 30). Dr. Ferber revisits his “crying baby” theory. NPR. https://www.npr.org/2006/05/30/5439359/dr-ferber-revisits-his-crying-baby-theory