Other approaches

Pick-up-put-down, camping out, bedtime fading and the dream feed.

About 7 minutes to read

4. Pick-up-put-down

This is the weakest-evidenced method on the page, and the page should say so. It is popular, gentle in intent, and nobody has tested it.

1. Into the cot awake After the usual routine.
2. Wait a moment Some babies settle in the pause.
3. If crying continues, pick them up Without waiting for it to escalate.
4. Hold until calm, but not until asleep The part families find hardest to judge.
5. Put them down again, still awake Calmly and without fuss.
6. Repeat as needed Room dark, interaction low-key throughout.
7. As your baby gets heavier, switch to a hand on the chest Comfort in the cot instead of lifting.

Evidence. None, in the formal sense. It does not appear as a category in the 2006 review, nor in Cerebra's guide, The Sleep Charity's pages or the Newcastle NHS sleep information. We found no randomised trial, no systematic review and no NHS source evaluating it, and no verified age range. That does not make it harmful. It means that if it works for you it works for you, and nobody can tell you how likely that is.

Who it may not suit. Babies who become more upset with repeated handling. Heavier babies, especially if you have a back or joint problem. Parents who want an evidence base before starting.

6. Camping out

Staying in the room while your child falls asleep, and becoming progressively less involved over several weeks. In the original trial, parents sat with their infant until the infant fell asleep and gradually removed their presence over three weeks. For children over six months.

The ELFT NHS protocol:

1. Choose one set phrase and use only that The same words every time.
2. Start where you are The distinctive part. If you currently co-sleep, you start from co-sleeping rather than making a leap first.
3. Move to the end of the bed Stay 20 minutes after your child is asleep before leaving.
4. Move to a chair beside the bed Present, but no longer on the bed.
5. Move the chair slightly away A small increment.
6. Keep moving further every three or four nights Until you are out of the room.
7. Wait for three or four consecutive successful nights before each move The nights set the pace.
8. No eye contact, no conversation Present, calm and uninteresting.

Evidence. Camping out was one of two options in the Australian trials behind the Hiscock and Price results: at the 2007 follow-up, sleep problems affected 56 per cent of the intervention group against 68 per cent of controls at 10 months (adjusted odds ratio 0.58), and 39 against 55 per cent at 12 months (odds ratio 0.50). Caveat: families chose between camping out and controlled comforting, and some mixed the two, so the trials cannot show how well camping out works on its own.

How long, and who it may not suit. About three weeks, longer if you hold each stage until it is consistent. Not for babies under six months, nor for parents who cannot spend every evening in a dark room, which includes most people with other children to put to bed and anyone doing this alone. Not for children who become more alert with a parent visible.

7. Bedtime fading

Bedtime fading, or bedtime shifting, moves bedtime later to match the time your child actually falls asleep, then walks it back earlier. It is counter-intuitive, and it is Cerebra's recommended alternative where controlled crying is contraindicated.

1. Keep a sleep diary for at least two weeks first The method is built on the times in it and does not work without one.
2. Take a time they fell asleep unaided and add 30 minutes That is the temporary bedtime. It will feel late. That is the point.
3. Do the routine 30 to 60 minutes before it Ending at the new, later bedtime.
4. Keep sleep onset in the bed, and do not leave them lying awake in bed for much more than 20 minutes Bedtime fading works by lining bedtime up with the time they actually fall asleep, so dropping off on the sofa, or a long wait in bed, stops it doing its job. That is a reason to adjust the timing, not a rule you have broken.
5. Use a response cost If they are still awake after 20 minutes, get them up for another hour of calm activity, then try again.
6. After two consecutive nights falling asleep within 20 minutes, move bedtime 15 minutes earlier Fifteen minutes a night, no faster.
7. If it stops working, hold at the last successful time Stay there until it settles again.
8. Keep a fixed wake time and no daytime sleep beyond age-appropriate naps The wake time anchors everything.
9. Expect to stay up yourself Cerebra is direct: you will need to stay up until the strategy is effective, which may take a few weeks.

Evidence. Less than for the extinction methods, and that should be said. The 2006 review found faded bedtime with response cost evaluated in one study, with no follow-up, and positive bedtime routines in two studies covering 81 children; it has been studied more in children with developmental disabilities than in the wider population. One comparison found positive routines improved tantrum behaviour fastest, matching extinction until about week four, when routines kept improving as extinction plateaued. Gradisar's 2016 trial found bedtime fading reduced time to fall asleep comparably to graduated extinction, with the advantage that it may reduce the surge of protest extinction produces.

How long, and who it may not suit. A few weeks on Cerebra's estimate, longer if there is a long way to walk the bedtime back. It does not fit households where a much later bedtime is impossible, because of early starts, shared bedrooms or other children sleeping, and it needs an adult awake late, which is hard alone. It also cannot be started tonight, because of the two weeks of diary.

8. The dream feed

A dream feed means offering a feed late in the evening, before you go to bed, without fully waking the baby, in the hope of a longer stretch afterwards. It is worth knowing that the term appears in no NHS, Sleep Charity, BASIS or Cerebra source we could find. The nearest concept in the research is the "focal feed".

1. Pick a fixed time between 10pm and midnight Offer a feed at about that time nightly.
2. Keep it dark, quiet and low-handling Minimal stimulation throughout.
3. Feed responsively Do not push for a volume. Your baby knows how much milk they need.
4. Settle back to sleep As you normally would.
5. Separately, lengthen the intervals before middle-of-the-night feeds Trying other comfort first.
6. Make the difference between day and night as clear as you can Bright and sociable by day, dim and dull at night.
7. Stop and speak to your health visitor if you have any concern about supply or weight gain That comes before any sleep goal.

Evidence. One small study, which does not show what it is usually said to show. Pinilla and Birch published in Pediatrics in 1993 with 26 first-time parents, 13 per group. By eight weeks all the treatment infants were sleeping through the night as that study defined it, against 23 per cent of controls, and reassuringly total 24-hour milk intake was comparable between groups. But the intervention was a three-component package, so the result cannot be attributed to the late feed alone. The 2006 review classes it under parent education and reports a replication failure: turned into a brochure, the package produced only a 10 per cent increase, with the group not implementing the essential components. No systematic review assesses dream feeding as a discrete intervention, and no UK NHS source recommends it.

Where that leaves it. Low-risk, and worth a try if you want to. Not evidence-based, and not worth persisting with if it makes the night worse. If you are breastfeeding and worried about supply, or weight gain has been a concern, speak to your health visitor before changing the pattern of feeds.