The Ferber Method: Is It Safe, When Can You Start & Does It Work?
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The Ferber method is a form of behavioral sleep training called graduated extinction. Parents put their baby down for sleep and, rather than responding immediately to every cry, wait for planned periods before briefly checking and reassuring the baby.
The goal is not to ignore a baby's needs. It is to give a developmentally ready baby opportunities to fall asleep without requiring the same parental help every time sleep begins or the baby awakens.
Behavioral sleep methods can improve sleep for some infants and families. Available randomized studies have not found evidence that graduated extinction causes long-term attachment or emotional harm, although research has limitations and cannot answer every question about every child.
Sleep training is an option—not a requirement. Families who do not want to use the Ferber method do not need to use it.
- The Ferber method is generally considered a form of graduated extinction.
- It is different from leaving a baby to cry without any planned parental checks.
- Newborns are not appropriate candidates for this type of sleep training.
- There is no single magic age or checking schedule appropriate for every baby.
- Feeding needs must be considered separately from sleep training.
- Parents should respond whenever they believe their baby may be sick, hungry when feeding is needed, injured or otherwise unsafe.
- Research shows behavioral sleep interventions can improve some infant sleep outcomes.
- Available studies have not demonstrated long-term harm to attachment or emotional development.
- Parents can choose another behavioral approach—or choose not to sleep train at all.
What Is the Ferber Method?
The Ferber method is named after pediatric sleep physician Dr. Richard Ferber and is commonly associated with a behavioral technique known as graduated extinction.
Parents sometimes describe it simply as “cry it out.”
That description misses an important distinction.
With graduated extinction, parents establish a bedtime routine, put the child down for sleep and allow predetermined periods of time before briefly returning to check and reassure the child.
The intervals between checks may gradually increase.
The purpose is to reduce the amount of parental intervention required for the child to fall asleep while still allowing planned reassurance.
Is Ferber the Same as Cry It Out?
Not exactly.
The terms are often used interchangeably online, but behavioral sleep medicine distinguishes different approaches.
Unmodified extinction generally involves putting the child to bed and not returning in response to crying unless there is a concern about illness, safety or another genuine need.
Graduated extinction involves waiting predetermined periods before briefly checking and reassuring the child.
The Ferber method is most closely associated with the second approach.
Sleep training should never mean turning off your parenting instincts.
If your baby's cry sounds different, your baby seems sick, feeding is needed or something simply does not seem right, go check your baby.
A behavioral plan does not override common sense or parental judgment.
When Can You Start the Ferber Method?
This is one of the most important questions parents ask—and one where overly simple internet advice can cause confusion.
Newborns should not be treated as sleep-training projects.
During early infancy, sleep-wake rhythms are immature and babies wake frequently for feeding, comfort and normal developmental reasons.
The American Academy of Pediatrics notes that babies do not develop regular sleep cycles until approximately 4 months of age.
Beginning around this developmental period, parents can increasingly encourage healthy sleep habits such as putting a baby down drowsy rather than fully asleep.
That does not mean every baby should begin the Ferber method on the day they turn 4 months old.
Development, feeding, growth, medical history, temperament and family preferences all matter.
Talk with your pediatrician before beginning a structured sleep-training program if your baby:
- Was born prematurely
- Has poor weight gain
- Still requires frequent nighttime feeding
- Has significant reflux or feeding difficulties
- Has breathing problems
- Has a chronic medical condition
- Has developmental concerns
- Is younger than the age at which you and your pediatrician feel behavioral sleep training is appropriate
How Does the Ferber Method Work?
The basic concept is straightforward.
- Choose an appropriate bedtime.
- Complete a calm, predictable bedtime routine.
- Make sure feeding, diapering and other immediate needs have been addressed.
- Place your baby in the safe sleep space while awake.
- Leave the room.
- If your baby cries, wait for a predetermined period before returning.
- Keep the check brief and reassuring.
- Leave again and repeat according to the plan you have chosen.
The intervals are usually increased gradually rather than responding immediately each time crying begins.
But there is an important point:
There is no medically required universal set of minute-by-minute intervals that every family must follow.
A Pediatrics clinical report describing graduated extinction specifically notes that the time between checks can be determined based on the child's temperament and the parents' tolerance for crying.
How Long Should I Let My Baby Cry?
Parents often expect a pediatrician to provide a precise answer:
“Three minutes? Five minutes? Ten minutes?”
There is no single evidence-based number that applies to every baby.
Graduated extinction uses planned intervals, but the exact timing can vary.
The more important issue is whether the approach is appropriate for your child and whether you can apply it calmly and consistently.
If an interval feels intolerable to you, using a longer interval simply because an internet chart says so is unlikely to make the process easier.
What Should I Do During a Check?
A check is intended to be brief reassurance rather than restarting the entire bedtime routine.
You might quietly speak to your baby or provide a brief reassuring touch.
Then leave again while the baby is awake.
If every check becomes 20 minutes of rocking, feeding or holding until fully asleep, the method is no longer functioning as graduated extinction.
There is another practical reality:
Some babies become more upset when a parent enters and then leaves again.
If repeated checks consistently intensify your child's distress, Ferber may simply not be the best behavioral approach for your family.
Does the Ferber Method Work?
Behavioral sleep interventions have evidence supporting their ability to improve certain sleep problems.
In a randomized trial published in Pediatrics, infants 6 to 16 months were assigned to graduated extinction, bedtime fading or sleep education.
Graduated extinction produced improvements in sleep measures including sleep latency, nighttime awakenings and time awake after sleep onset.
That does not mean every baby responds identically.
Sleep problems have different causes, and no behavioral technique works for every child or every family.
Will the Ferber Method Damage My Baby's Attachment?
This is probably the question that causes parents the most anxiety.
Available randomized research has not demonstrated that graduated extinction causes attachment problems.
In the randomized trial of infants 6 to 16 months, researchers found no significant differences in secure versus insecure attachment at 12-month follow-up.
Another randomized behavioral sleep intervention followed children for approximately five years and found no evidence of meaningful differences in child mental health, parent-child relationship measures, stress regulation or parenting outcomes.
That is reassuring.
But good medical communication also requires acknowledging what the evidence cannot tell us.
No study can prove that a behavioral method is risk-free for every child in every family. Studies have sample-size, follow-up and design limitations.
The reasonable conclusion is that the available evidence does not support claims that appropriately used behavioral sleep interventions cause long-term attachment or emotional damage.
Does Crying Raise a Baby's Cortisol?
Crying and stress are closely linked in parents' minds, and cortisol is often mentioned in discussions about sleep training.
The 2016 randomized trial measured infant salivary cortisol and did not find evidence that graduated extinction produced an adverse stress response compared with the control condition.
That finding is reassuring, but cortisol measurements from a relatively small study should not be turned into sweeping claims about every infant's emotional experience.
The stronger conclusion is that this trial did not demonstrate the harmful stress effect sometimes attributed to graduated extinction.
Does Sleep Training Mean Stopping Night Feeds?
No.
This distinction is extremely important.
Sleep training and night weaning are not the same decision.
A baby may be developmentally capable of learning different sleep-onset habits and still need nighttime nutrition.
Whether your baby can safely reduce or stop night feeds depends on factors including:
- Age
- Growth
- Weight gain
- Prematurity
- Daytime intake
- Breastfeeding or feeding circumstances
- Medical history
Do not withhold a medically necessary feeding simply because you are following a sleep-training plan.
“Learning to fall asleep” and “no longer needing to eat at night” are two completely different pediatric questions.
Don't let a sleep-training chart make a feeding decision for your baby.
What If My Baby Vomits While Crying?
Some babies may gag or vomit during intense crying.
If your baby vomits, go to your baby.
Make sure your baby is breathing normally and appears well.
Clean your baby and the sleep environment as needed, replace soiled bedding with a clean fitted sheet and provide appropriate reassurance.
Do not leave vomit in the crib in an effort to remain “consistent.”
If vomiting is repeated, forceful, associated with illness, breathing difficulty, poor feeding or other concerning symptoms, stop the sleep-training attempt and contact your pediatrician.
What If My Baby Is Sick?
Illness changes the equation.
A baby with fever, breathing difficulty, significant congestion, vomiting, diarrhea, pain or unusual behavior may need comfort, fluids, feeding or medical evaluation.
Sleep training can wait.
You do not lose all previous progress because you respond more frequently to a sick child.
Once your child has recovered, you can return to your usual sleep routine.
What If My Baby Is Teething?
Teething can temporarily make some babies uncomfortable.
If your baby seems to be in pain, address the discomfort appropriately rather than assuming every cry is behavioral.
At the same time, teething can last intermittently for a long period, so families do not necessarily need to abandon every sleep routine whenever a tooth is emerging.
Use your judgment based on how your child is acting.
What If Checking Makes the Crying Worse?
This happens.
Some babies calm when they briefly see a parent.
Others become furious when the parent appears and then leaves.
That does not mean something is wrong with your baby.
It may mean that a graduated-checking approach is a poor match for your child's temperament.
Other behavioral approaches exist, including gradually reducing parental presence or adjusting bedtime to better match when the child naturally becomes sleepy.
You do not have to force Ferber to work.
What If I Can't Stand Hearing My Baby Cry?
Then this may not be the right method for you.
That is a perfectly reasonable conclusion.
Parents differ enormously in their tolerance for crying, just as babies differ in temperament.
A sleep method that leaves a parent extremely distressed night after night may not be sustainable.
There are gentler, more gradual approaches to changing sleep habits, and there is no pediatric requirement that every family use graduated extinction.
Do Both Parents Have to Agree?
Ideally, the adults caring for the baby should agree on the basic approach before bedtime arrives.
One parent waiting while the other repeatedly intervenes can create frustration for everyone.
Discuss beforehand:
- What bedtime routine you will use
- How you will respond to crying
- Who will perform checks
- How feeding will be handled
- What circumstances mean you will stop and respond immediately
A simple plan made at 6 p.m. is easier to follow than a complicated argument at 2 a.m.
Does Safe Sleep Still Apply During Sleep Training?
Absolutely.
Sleep training never changes infant safe-sleep recommendations.
- Place your baby on the back to begin every sleep.
- Use a firm, flat, noninclined infant sleep surface.
- Keep pillows, loose blankets, stuffed animals, bumpers and other soft objects out of the sleep area.
- Do not use a swing, bouncer, car seat or other sitting device as a routine sleep-training location.
- Do not add positioners, weighted products or padding to encourage sleep.
The goal is to change a sleep behavior—not to compromise the baby's sleep environment.
When Should You Stop and Check Your Baby?
A sleep-training interval should never prevent you from responding when you believe your baby needs you.
- The cry suddenly sounds unusual or painful.
- Your baby is having difficulty breathing.
- Your baby has vomited.
- Your baby may be sick or feverish.
- A feeding is due or you believe your baby is genuinely hungry.
- Your baby may have a soiled diaper that needs attention.
- You have any concern about your baby's safety.
- Your parental instinct tells you something is different.
You do not “ruin” sleep training by appropriately caring for your child.
Who Should Talk With the Pediatrician Before Sleep Training?
Most healthy, developmentally appropriate older infants do not need a special medical evaluation simply because their parents are considering behavioral sleep strategies.
But individual guidance is particularly useful if your baby has:
- Poor weight gain
- Prematurity
- Feeding problems
- Significant vomiting
- Chronic respiratory problems
- Persistent snoring or noisy breathing
- Pauses in breathing
- Developmental or neurologic concerns
- A chronic medical condition
- An unusual or sudden change in sleep
Sometimes what appears to be a behavioral sleep problem has a medical contributor that deserves attention first.
Are There Alternatives to the Ferber Method?
Yes.
Ferber is one behavioral approach among several.
Other strategies may include:
- Consistent bedtime routines
- Bedtime fading
- Gradual reduction of parental presence
- Gradually reducing rocking or other sleep associations
- Responsive settling approaches
The best approach is one that is developmentally appropriate, safe and realistic for your family.
Parents do not receive extra credit for choosing the method involving the most crying.
Frequently Asked Questions
What is the Ferber method?
The Ferber method is commonly associated with graduated extinction, in which parents allow planned periods before briefly checking and reassuring a child who is crying at bedtime.
Is the Ferber method the same as cry it out?
Not exactly. Unmodified extinction generally involves not returning in response to crying unless there is a safety, illness or other genuine concern. Graduated extinction includes planned parental checks.
What age can I start the Ferber method?
There is no universal birthday on which every baby becomes ready. Newborns are not appropriate candidates. Sleep organization becomes more mature around 4 months, but developmental readiness, feeding, growth and medical history should be considered before beginning a structured program.
How long should I let my baby cry?
There is no single medically required interval for every child. Graduated extinction uses predetermined periods between brief checks, and the intervals can be individualized according to the child's temperament and the parents' tolerance.
Will Ferber damage my baby's attachment?
Available randomized studies have not demonstrated long-term attachment or emotional harm from behavioral sleep interventions such as graduated extinction. Research has limitations, so it is more accurate to say that evidence has not demonstrated the harm rather than claiming that every possible risk has been disproven.
Do I have to stop night feeds to use Ferber?
No. Sleep training and night weaning are separate decisions. Some babies still require nighttime nutrition. Ask your pediatrician if you are uncertain whether your baby's growth and feeding pattern make reducing night feeds appropriate.
What if my baby vomits while crying?
Go to your baby, make sure the baby is well, clean the baby and sleep area, and provide appropriate reassurance. Repeated or concerning vomiting deserves medical attention rather than simply continuing the sleep-training interval.
What if the Ferber method doesn't work?
Stop and reassess. Your baby's schedule, feeding, illness, temperament or sleep environment may be contributing. Another behavioral approach may also be a better fit for your family.
Do I have to sleep train my baby?
No. Sleep training is an optional parenting strategy, not a developmental requirement. Families can choose the approach that works best for them while maintaining safe infant sleep practices.
Dr. G's Pearl
There is no medal for getting your baby to sleep with the least parental involvement.
The Ferber method can be a useful tool for some families. It is not a test of good parenting, and choosing not to use it does not mean you are creating a bad sleeper.
If you decide to try it, make sure your baby is developmentally ready, feeding and growing appropriately, and sleeping in a safe environment.
Then choose a plan you can actually follow.
Good sleep advice should fit the child and the family—not force every family into the same formula.
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References
- Gradisar M, Jackson K, Spurrier NJ, et al. Behavioral Interventions for Infant Sleep Problems: A Randomized Controlled Trial. Pediatrics. 2016;137(6):e20151486.
- Price AMH, Wake M, Ukoumunne OC, Hiscock H. Five-Year Follow-up of Harms and Benefits of Behavioral Infant Sleep Intervention: Randomized Trial. Pediatrics. 2012;130(4):643-651.
- American Academy of Pediatrics. Getting Your Baby to Sleep. HealthyChildren.org.
- Meltzer LJ, Williamson AA. Sleep Disorders in Children. Pediatrics. 2022;150(6):e2022060055.
Related Parent Resources
Explore more pediatric guidance about bedtime, nighttime waking, sleep training and healthy sleep habits in the Pediatric Parent Guide Sleep Library.