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Since becoming a mother, Jenn Wong had followed all the usual baby sleep advice for her son. She kept his room pitch-black and ran a white-sound machine. She made sure her son had a consistent bedtime routine. She even successfully sleep-trained him - a process to help babies learn how to fall asleep by themselves - at 9 months old.
But at 18 months old, after he started day care, it all fell apart. He woke up many times a night, sometimes every one to two hours, and wouldn't go back to sleep without her. "I was back at work at that point and ready to try anything to get him sleeping longer stretches," said Wong, 35, of Ottawa, and it wasn't working. "My husband and I were at our wits' end."
So they hired a sleep consultant with a large following on Instagram who charged $500 for two weeks of virtual support, including an "individualized" sleep-training plan they hoped would get things back on track.
Kasia Donohue paid a sleep coach to help her when her son was 4 months old. His many nighttime awakenings did stop, but only temporarily.
"I bragged to everyone my kid slept through the night … until he didn't," said Donohue, 46, of Saugerties, N.Y. "The sleep-training process as far as the consultant experience was very positive, but the results weren't."
Sleep consultants, or sleep coaches, are an unlicensed provider group that offers education, advice and support services to help improve a child's sleep - and the parents'. "I don't want to say it cures postpartum depression, but getting some sleep makes an enormous difference in your life as a mom," said sleep consultant Mary Vaughn. "Once you have your kids sleeping, it's such a magical thing - and you want to share it with everybody else."
Vaughn sleep-trained her son at 6 months old using the Ferber method, which instructs parents to let their babies cry alone for a short, predetermined period of time before going in briefly to comfort them. Both Vaughn's and her baby's sleep improved dramatically within three nights.
The experience inspired Vaughn, now a mother of four, to become certified as a sleep consultant and start her own business, Mother Together, in 2019. She has worked with hundreds of clients, typically charging $400 to $500 for two weeks of text and email support.
In the last decade, Vaughn said, the baby sleep consultant industry "has just exploded. … It's a lot of, like, 'I'm going back to work, I desperately need a schedule, and I need to know that my kid is going to sleep.'"
The rise of baby sleep consultants can be partly attributed to parents seeking expertise in an area that pediatricians report often knowing little about. Since 2007, the American Board of Pediatrics has certified 251 sleep sub-specialists, and the American Board of Family Medicine, 138. That's out of more than 100,000 general pediatricians and more than 75,000 general family practitioners.
Pediatric sleep centers accredited by the American Academy of Sleep Medicine exist, but are mostly in large metropolitan areas and may require a specialty referral.
"Pediatricians are not well-trained in sleep, so parents are left with this vastness of not really having a great resource to go to," said Jodi Mindell, associate director of the Sleep Center at Children's Hospital of Philadelphia, who specializes in pediatric sleep disorders.
"But sleep consultants run the gamut - from licensed providers to people who may not even have a high school education - so parents have to be really careful," she said. There is no universally accepted definition of "sleep consultant" or "sleep coach," nor are there clear guidelines on training requirements or scope of practice.
Physicians, psychologists, nurses and other licensed health professionals are not allowed to provide services in states other than where they are licensed. Sleep consulting does not require state licensing, and with no national or international regulations on who can practice, the majority of sleep consultants serve clients outside their home state or country.
"The other concern with sleep consultants is they're [mostly] not taking insurance," said Mindell. "So they're unaffordable for the majority of families, versus a sleep center or licensed provider who insurance may cover."
Gemma Stern, a clinical psychologist at Columbia University Irving Medical Center, surveyed 100 sleep coaches across the country for her 2023 dissertation research for her doctor of psychology degree. Most clients were wealthy, White, married heterosexual couples who live in a suburb or large city. She also found that, on average, the consultants charged $213 an hour for an in-person consultation, $138 an hour for a phone or virtual consultation, and $650 for an overnight package.
In 2016, Mindell and her colleagues surveyed 142 sleep coaches around the world to better understand the landscape of sleep consulting services. Half of respondents had completed a bachelor's degree as their highest level of education, with the most common major being psychology.
A quarter of the coaches' undergraduate degrees were in majors not related to sleep consulting, such as marketing, architecture, political science or American studies. And 12 percent had only a high school degree. A third of those surveyed had no health-care experience before becoming a sleep coach.
A 2015 study looked at the websites of more than 100 sleep coaches in the United States for data on training. All respondents cited a certification or training program, but the requirements for each varied considerably. Some demanded months of online coursework, while others required only a few days of training.
Marie-Hélène Pennestri, director of the Pediatric Sleep Laboratory at McGill University, said parents seeking a sleep consultant should find out whether they have any professional training: "My advice to parents would be to clarify, what is their training? Is this individual a licensed psychologist? Is this person part of an order?"
Other important questions to consider, according to Pennestri and Mindell: How long has the person been practicing as a sleep coach? How many families has the person served? What is the person's sleep coaching philosophy? What happens if the plan does not seem to be working?
Both Vaughn and Mindell said they hope sleep consulting will take a similar path toward professionalism as lactation consulting. In the 1970s and '80s, lactation consultation emerged as a profession in response to growing demand by mothers for specialized breastfeeding support and care. The International Board of Lactation Consultant Examiners (IBLCE) was founded in 1985 to bring standards to the field.
To become a lactation consultant certified by the board, individuals must complete both health sciences and lactation-specific education, gain 300 to 1,000 hours of lactation-specific clinical experience, and pass a four-hour certification exam. Consultants also must be recertified every five years to maintain their credential.
"In the lactation world, which I always think of as a similar area [to sleep coaching], the lactation consultants have done this amazing job," said Mindell. "They have an organization and accreditation system that is independent of any training. There isn't for sleep consultants, but I and many others would love to see the field go in that direction."
As a health-care professional - a clinical dietitian who works at a hospital - Wong said she felt uneasy about some of the sleep consultant's recommendations for her son. For example, the consultant told her to check in at 15-minute intervals, even when her son was sick with one of his many day-care illnesses.
"Kids cry because they are uncomfortable or want more love and affection, but their advice was, 'Give him the medication and continue with the plan,'" said Wong, who tried her best to stick to the routine. "That advice did not sit so well with me, knowing that they're not a health professional."
Her son, now 3, finally started sleeping through the night at 2 years old, after two more months of staying consistent with sleep training. It took an additional eight to nine months before he stopped crying himself to sleep. But Wong is not sure whether it was the sleep consultant's plan kicking in or a developmental skill that would have happened around 2 years old anyway.
In Donohue's case, even though the first consultation didn't produce the results she was desperate for, she still believes in the value of bringing in an expert to help exhausted parents. But she is convinced that some kids are "just not good sleepers," in the same way that many adults have trouble with sleep.
"For so long, I've beat myself up for not sticking with the program or being strict enough with the rules of sleep training," said Donohue, whose child is now 2. "But now I know that how he sleeps - or doesn't - isn't a reflection on me."
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