Ask Dr. Hirsch: Weekly Q&A with Dr. Shari Hirsch, Pediatrician and Lactation Specialist at Lev Pediatric Care

This Week’s Question:
“Sleep training feels confusing and controversial. When should we start, and what actually helps?”

Dr. Hirsch’s Answer:
If you’ve ever typed “sleep training” into a search bar at 2 a.m. while bouncing a baby and hoping for just one decent stretch of sleep, welcome. You are not alone.

Sleep training might be one of the most debated parenting topics out there. Everyone seems to have a strong opinion, and that can leave parents overwhelmed. So let’s take a breath, tune out the noise, and focus on what’s useful, what’s optional, and what actually helps.

Before sleep training, start with sleep shaping.
In the first few months, babies are not developmentally ready for formal sleep training. Their feeding needs and sleep cycles are still in newborn mode. What you can do instead is sleep shaping, meaning gentle changes that set the stage for longer stretches later on.

Two examples of sleep shaping are slowly stretching awake windows as your baby grows, and gently widening the time between daytime feeds without pushing too far. A simple rule is not to stretch beyond four hours unless your baby is doing that naturally. Hungry babies do not sleep better.

When can babies sleep through the night?
With pediatrician approval, many babies around six months can go ten to twelve hours overnight without eating. But many, especially breastfed babies, do not. Breast milk digests quickly, nighttime calories can still matter, and some babies just need a feed or two overnight. If your baby is waking to nurse at eight or nine months, that can still be completely normal.

So when do you start actual sleep training?
If your baby is over six months old, growing well, has no medical concerns, and your pediatrician gives the green light, you can consider sleep training if you want to. Some families choose it. Some don’t. Both are valid. The goal is to help your baby fall asleep independently and link sleep cycles. That is a developmental skill, not a parenting trophy.

A word about methods.
There are many approaches. Some involve leaving a baby to cry for increasing intervals. Some providers recommend that. Others don’t. The research is mixed. My own approach is to start with gentler methods first, because they often work just as well without the stress. If a method feels wrong for your family, trust that instinct.

Small things that help either way.
Keep the sleep space dark and quiet. Use white noise if it helps. During night wakings, keep lights off and stimulation low. The calmer and more consistent nights feel, the easier it is for babies to settle.

Bottom line.
Sleep training is not one size fits all. Start with gentle sleep shaping, follow your baby’s cues, and choose an approach that fits your family and your comfort level. If you want help making a plan, your pediatrician can guide you through it.

​Dr. Shari Hirsch, MD, specializes in infant feeding, including expert newborn support, lactation guidance, and frenotomy (tongue-tie release). She also offers emotional wellness care, with guidance and medication management for attention, mood, and anxiety support.

Lev Pediatric Care is located at Evergreen Uptown Mall in Pomona. Their hours are Sunday through Thursday, 10:00 am to 7:45 pm, and Friday, 10:00 am to 1:00 pm. Same-day appointments are available. To schedule, call 845-579-5700. They also provide free car service to and from doctor visits.

Have a question for next week’s column? Send it to Lev Pediatric Care, and Dr. Hirsch may feature it in an upcoming Q&A