What is controlled comforting?

Controlled comforting is a behaviour management strategy for dealing with persistent settling and waking problems in young children.

Controlled comforting involves quickly checking and reassuring your baby while he’s adjusting to a new way of getting to sleep.

The idea behind controlled comforting is to help children get used to settling themselves to sleep, rather than feeding, patting or cuddling them to sleep.

Is controlled comforting safe?
Controlled comforting has been found to be safe and effective. Babies whose parents have used controlled comforting are more likely to sleep better in the short term.

Some parents worry that controlled comforting will hurt their relationship with their child. When this settling strategy is used appropriately, there’s no evidence of harm. But if you’re unsure or you’d like advice about your baby’s sleep, talk with your child and family health nurse, GP or paediatrician.

Controlled comforting, controlled crying, crying it out: what’s the difference?

Controlled comforting is sometimes called controlled crying.

Controlled comforting is different from crying it out, where a baby is left to cry until she falls asleep. Crying it out isn’t recommended by child health professionals because it isn’t safe or effective in helping children get to sleep by themselves. Crying it out is sometimes called extinction crying.

Is controlled comforting right for your family?

To help you decide whether controlled comforting is right for you and your baby, take a few minutes to consider the following questions. If you answer ‘yes’ to all these questions, controlled comforting might be worth a try:

  • Is your baby aged between six months and two years old? In particular, controlled comforting is not recommended for babies under six months.
  • Are you and your baby both well? If you think illness might be why your baby isn’t settling, talk to a GP or child and family health nurse. Also, it’s best not to commit to this strategy if you’re unwell, because the strategy needs time and patience.
  • Do you think your baby is comfortable when you’re not in sight? If she isn’t, it might be separation anxiety. Although separation anxiety is normal, it can make it harder to do controlled comforting.
  • Can you recognise your baby’s early tired signs? The strategy works best when babies are sleepy, but not overtired.
  • Do you have enough time to play with your baby when he’s awake? And do you enjoy playing with your baby and sharing affection? These are good signs that your relationship is developing well, and you have good attachment.
  • Are things stable in your family, without big changes like a new baby, a house move or other stresses? Controlled comforting won’t be helpful if other things are causing your baby stress.
  • Do you and your partner agree that controlled crying might be an option for you? If you have a partner, you need to work as a team.
  • Have you got time for controlled comforting? It takes around 3-14 days to work, and you need to do it during the day and at night. It’s best to avoid important commitments for the first few days after you start.
Working with a trusted child health professional can help you to improve your baby’s sleep. You could think about getting this kind of support before you try controlled comforting. Read more about getting help with settling babies.

How to do controlled comforting

The steps below involve comforting your baby and then leaving her for a set amount of time, before you go back to comfort her again. You’re aiming to give your baby the chance to settle by herself, and to learn that you’re not far away and you’ll eventually come back.

  1. Establish a consistent and positive bedtime routine.
  2. When it’s time to say goodnight, put your baby in her cot. Comfort your baby with talking or patting until she’s quiet, or for one minute.
  3. As soon as your baby is quiet, or after one minute, say goodnight and leave the room. Leave before your baby is asleep.
  4. Stay out of the bedroom and give your baby a chance to settle by herself. Your baby might grizzle as she starts to settle. Don’t go back to the bedroom if your baby is grizzling.
  5. If your baby starts to cry, wait for a set amount of time before going back to your baby – for example, two minutes at first.
  6. Leave your baby for a sequence of set time intervals – for example, 2, 4, 6, 8 and 10 minutes.
  7. If your baby is still upset after each time interval has passed, return briefly. Talk to your baby or pat her for one minute, or continue talking or patting until she’s quiet, depending on your preference. Try to soothe her without picking her up if you can.
  8. As soon as your baby is quiet (or after one minute) but before she’s asleep, leave the room again and wait for the next set time interval.
  9. Continue until your baby falls asleep by herself.
  10. When your baby wakes overnight, check that she’s comfortable – for example, not too hot or too cold, and not needing a nappy change. Then follow the routine again, starting from step 2.

If things haven’t improved after two weeks, talk to your GP or child and family health nurse. They’ll be able to help you develop a program tailored to the needs of your child.

It’s OK to adapt the steps above, depending on what you and your baby are comfortable with. For example, you can set your own intervals or keep your intervals at two minutes, rather than extending them to four minutes.

Important tips for controlled comforting

These tips can help controlled comforting go well:

  • Use a clock or your mobile phone to time intervals – even two minutes can seem like a long time.
  • Make sure you can still hear your baby.
  • Don’t wait outside your baby’s bedroom. Go into another room and distract yourself, perhaps by making a cup of tea or turning on the TV. Go back to check on your baby when the set time is up.
  • Keep an eye on your baby’s nappy. If it’s dirty, change him under low light and with minimal fuss.
  • Remember to leave your baby’s room before she falls asleep.
  • Always ensure that your baby has had enough to eat during the day. Hungry babies can find it difficult to settle and might wake during the night.
  • If you’re doing controlled comforting and you have a partner, work out what role each of you will play – for example, helping with resettling or timing the intervals. Consider taking turns each night.
If you use this strategy for daytime sleeps as well, your baby will be less confused by this new way of getting to sleep. If your baby wakes up from a day sleep after less than an hour, try to re-settle him for another 15-20 minutes, again using controlled comforting. If your baby hasn’t gone back to sleep after that time, get him out of bed and try again later.

Common problems with controlled comforting

Putting a sleep behaviour strategy into practice doesn’t always go smoothly. Here are some common problems with controlled comforting and practical tips for dealing with them.

What if your baby is unwell?
If your baby is unwell, you should stop controlled comforting and start again when she’s better. If she has a slight runny nose and cough but no fever, you can still use controlled comforting if you’re happy to do so.

What if your baby is in pain?
You might be concerned about teething causing pain. If you pick up your baby and he settles almost immediately, it’s very unlikely he was in pain – he just wanted to be picked up. You can give paracetamol if you’re concerned. Paracetamol takes about 20 minutes to work, so babies who settle after that might have been in pain.

If you have persistent concerns about your baby being in pain, talk to your GP.

What if you’ve had enough?
If you’re too tired or feeling too distressed or upset, pick up your baby, calm her in any way you want – for example, with a small drink or a cuddle – and try again the next time your baby needs to sleep, or when you’re ready.

What if controlled comforting isn’t working?

There can be several reasons why a sleep program doesn’t seem to be working.

Are you using the strategy correctly?
To check, re-read the steps described here. Is there anything you’re not doing, or could do differently? Perhaps check with a professional who understands the use of this strategy.

Are you going in when your baby is only grizzling, not crying?
Many babies grizzle when drifting off to sleep. By going in when your baby is grizzling, you might be stopping your baby from falling asleep.

Do you really want to go through with this?
Is the goal of uninterrupted sleep worth it for you and your baby? If you’re sure that sleeping independently through the night is right for you and your baby, try reminding yourself that your baby will adjust to this new way of getting to sleep in 3-14 days. If you’re not sure, it might be best to go back to what you were doing before.

Does your support network support controlled comforting?
Not everyone agrees with controlled comforting. You might be able to cope with disapproving family or friends, but if your partner or other close support people don’t agree with this strategy, it will be hard to go through with it. It’s best if at least the people in your home can agree on a consistent approach.